The Prevalence, Risk Factors, and Outcomes of Sepsis in Critically Ill Patients in China: A Multicenter Prospective Cohort Study
Background: Sepsis is a main cause of morbidity and mortality in critically ill patients. The epidemiology of sepsis in high-income countries is well-known, but information on sepsis in middle- or low-income countries is still deficient, especially in China. The purpose of this study was to explore...
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Frontiers Media S.A.
2020-12-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2020.593808/full |
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| author | Meiping Wang Meiping Wang Li Jiang Bo Zhu Wen Li Bin Du Yan Kang Li Weng Tiehe Qin Xiaochun Ma Duming Zhu Yushan Wang Qingyuan Zhan Meili Duan Wenxiong Li Bing Sun Xiangyuan Cao Yuhang Ai Tong Li Xi Zhu Jianguo Jia Jianxin Zhou Yan He Xiuming Xi China Critical Care Sepsis Trial (CCCST) workgroup |
| author_facet | Meiping Wang Meiping Wang Li Jiang Bo Zhu Wen Li Bin Du Yan Kang Li Weng Tiehe Qin Xiaochun Ma Duming Zhu Yushan Wang Qingyuan Zhan Meili Duan Wenxiong Li Bing Sun Xiangyuan Cao Yuhang Ai Tong Li Xi Zhu Jianguo Jia Jianxin Zhou Yan He Xiuming Xi China Critical Care Sepsis Trial (CCCST) workgroup |
| author_sort | Meiping Wang |
| collection | DOAJ |
| description | Background: Sepsis is a main cause of morbidity and mortality in critically ill patients. The epidemiology of sepsis in high-income countries is well-known, but information on sepsis in middle- or low-income countries is still deficient, especially in China. The purpose of this study was to explore the prevalence, characteristics, risk factors, treatment, and outcomes of sepsis in critically ill patients in tertiary hospitals in China.Methods: A multicenter prospective observational cohort study was performed with consecutively collected data from adults who stayed in any intensive care unit (ICU) for at least 24 h; data were collected from 1 January 2014 to 31 August 2015, and patients were followed until death or discharge from the hospital.Results: A total of 4,910 patients were enrolled in the study. Of these, 2,086 (42.5%) presented with sepsis or septic shock on admission to the ICU or within the first 48 h after admission to the ICU. ICU mortality was higher in patients with sepsis (13.1%) and septic shock (39.0%) and varied according to geographical region. Acinetobacter, Pseudomonas, and Staphylococcus infections were associated with increased ICU mortality. In addition, age, Acute Physiology, and Chronic Health Evaluation II (APACHE II) scores, pre-existing cardiovascular diseases, malignant tumors, renal replacement therapy (RRT), and septic shock were independent risk factors for mortality in patients with sepsis. The prompt administration of antibiotics (OR 0.65, 95% CI 0.46–0.92) and 30 mL/kg of initial fluid resuscitation during the first 3 h (OR 0.43, 95% CI 0.30–0.63) improved the outcome in patients with septic shock.Conclusions: Sepsis was common and was associated with a high mortality rate in critically ill patients in tertiary hospitals in China. The prompt administration of antibiotics and 30 mL/kg fluid resuscitation decreased the risk of mortality. |
| first_indexed | 2024-12-14T18:29:37Z |
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| id | doaj.art-d3fd3f2cacd945ac989355dea2b9336a |
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| issn | 2296-858X |
| language | English |
| last_indexed | 2024-12-14T18:29:37Z |
| publishDate | 2020-12-01 |
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| series | Frontiers in Medicine |
| spelling | doaj.art-d3fd3f2cacd945ac989355dea2b9336a2022-12-21T22:51:50ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2020-12-01710.3389/fmed.2020.593808593808The Prevalence, Risk Factors, and Outcomes of Sepsis in Critically Ill Patients in China: A Multicenter Prospective Cohort StudyMeiping Wang0Meiping Wang1Li Jiang2Bo Zhu3Wen Li4Bin Du5Yan Kang6Li Weng7Tiehe Qin8Xiaochun Ma9Duming Zhu10Yushan Wang11Qingyuan Zhan12Meili Duan13Wenxiong Li14Bing Sun15Xiangyuan Cao16Yuhang Ai17Tong Li18Xi Zhu19Jianguo Jia20Jianxin Zhou21Yan He22Xiuming Xi23China Critical Care Sepsis Trial (CCCST) workgroupDepartment of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, ChinaDepartment of Critical Care Medicine, Fuxing Hospital, Capital Medical University, Beijing, ChinaDepartment of Critical Care Medicine, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Critical Care Medicine, Fuxing Hospital, Capital Medical University, Beijing, ChinaDepartment of Critical Care Medicine, Fuxing Hospital, Capital Medical University, Beijing, ChinaMedical Intensive Care Unit, Peking Union Medical College Hospital, Beijing, ChinaDepartment of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, ChinaMedical Intensive Care Unit, Peking Union Medical College Hospital, Beijing, ChinaDepartment of Critical Care Medicine, Guangdong Geriatric Institute, Guangdong General Hospital, Guangdong, ChinaDepartment of Critical Care Medicine, The First Affiliated Hospital of China Medical University, Shenyang, ChinaSurgical Intensive Care Unit, Department of Anaesthesiology, ZhongShan Hospital, FuDan University, Shanghai, ChinaIntensive Care Unit, The First Hospital of Jilin University, Changchun, China0Department of Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China1Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China2Surgical Intensive Care Unit, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China3Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China4Department of Critical Care Medicine, General Hospital of Ningxia Medical University, Ningxia, China5Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, China6Department of Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, China7Department of Critical Care Medicine, Peking University Third Hospital, Beijing, China8Surgical Intensive Care Unit, Xuanwu Hospital, Capital Medical University, Beijing, China9Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, ChinaDepartment of Critical Care Medicine, Fuxing Hospital, Capital Medical University, Beijing, ChinaBackground: Sepsis is a main cause of morbidity and mortality in critically ill patients. The epidemiology of sepsis in high-income countries is well-known, but information on sepsis in middle- or low-income countries is still deficient, especially in China. The purpose of this study was to explore the prevalence, characteristics, risk factors, treatment, and outcomes of sepsis in critically ill patients in tertiary hospitals in China.Methods: A multicenter prospective observational cohort study was performed with consecutively collected data from adults who stayed in any intensive care unit (ICU) for at least 24 h; data were collected from 1 January 2014 to 31 August 2015, and patients were followed until death or discharge from the hospital.Results: A total of 4,910 patients were enrolled in the study. Of these, 2,086 (42.5%) presented with sepsis or septic shock on admission to the ICU or within the first 48 h after admission to the ICU. ICU mortality was higher in patients with sepsis (13.1%) and septic shock (39.0%) and varied according to geographical region. Acinetobacter, Pseudomonas, and Staphylococcus infections were associated with increased ICU mortality. In addition, age, Acute Physiology, and Chronic Health Evaluation II (APACHE II) scores, pre-existing cardiovascular diseases, malignant tumors, renal replacement therapy (RRT), and septic shock were independent risk factors for mortality in patients with sepsis. The prompt administration of antibiotics (OR 0.65, 95% CI 0.46–0.92) and 30 mL/kg of initial fluid resuscitation during the first 3 h (OR 0.43, 95% CI 0.30–0.63) improved the outcome in patients with septic shock.Conclusions: Sepsis was common and was associated with a high mortality rate in critically ill patients in tertiary hospitals in China. The prompt administration of antibiotics and 30 mL/kg fluid resuscitation decreased the risk of mortality.https://www.frontiersin.org/articles/10.3389/fmed.2020.593808/fullsepsisseptic shockmortalityprevalancerisk factor |
| spellingShingle | Meiping Wang Meiping Wang Li Jiang Bo Zhu Wen Li Bin Du Yan Kang Li Weng Tiehe Qin Xiaochun Ma Duming Zhu Yushan Wang Qingyuan Zhan Meili Duan Wenxiong Li Bing Sun Xiangyuan Cao Yuhang Ai Tong Li Xi Zhu Jianguo Jia Jianxin Zhou Yan He Xiuming Xi China Critical Care Sepsis Trial (CCCST) workgroup The Prevalence, Risk Factors, and Outcomes of Sepsis in Critically Ill Patients in China: A Multicenter Prospective Cohort Study Frontiers in Medicine sepsis septic shock mortality prevalance risk factor |
| title | The Prevalence, Risk Factors, and Outcomes of Sepsis in Critically Ill Patients in China: A Multicenter Prospective Cohort Study |
| title_full | The Prevalence, Risk Factors, and Outcomes of Sepsis in Critically Ill Patients in China: A Multicenter Prospective Cohort Study |
| title_fullStr | The Prevalence, Risk Factors, and Outcomes of Sepsis in Critically Ill Patients in China: A Multicenter Prospective Cohort Study |
| title_full_unstemmed | The Prevalence, Risk Factors, and Outcomes of Sepsis in Critically Ill Patients in China: A Multicenter Prospective Cohort Study |
| title_short | The Prevalence, Risk Factors, and Outcomes of Sepsis in Critically Ill Patients in China: A Multicenter Prospective Cohort Study |
| title_sort | prevalence risk factors and outcomes of sepsis in critically ill patients in china a multicenter prospective cohort study |
| topic | sepsis septic shock mortality prevalance risk factor |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2020.593808/full |
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