Prevalence of sepsis among adults in China: A systematic review and meta-analysis

BackgroundSepsis is a major public health problem that cannot be ignored in China and even in the world. However, the prevalence of sepsis in Chinese adults varies among different studies.ObjectiveTo evaluate the prevalence of hospital-wide sepsis and intensive care unit (ICU) sepsis in Chinese adul...

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Main Authors: Siyuan Lei, Xuanlin Li, Hulei Zhao, Yang Xie, Jiansheng Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-10-01
Series:Frontiers in Public Health
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2022.977094/full
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author Siyuan Lei
Xuanlin Li
Xuanlin Li
Hulei Zhao
Yang Xie
Jiansheng Li
Jiansheng Li
author_facet Siyuan Lei
Xuanlin Li
Xuanlin Li
Hulei Zhao
Yang Xie
Jiansheng Li
Jiansheng Li
author_sort Siyuan Lei
collection DOAJ
description BackgroundSepsis is a major public health problem that cannot be ignored in China and even in the world. However, the prevalence of sepsis in Chinese adults varies among different studies.ObjectiveTo evaluate the prevalence of hospital-wide sepsis and intensive care unit (ICU) sepsis in Chinese adults.MethodsPubMed, EMBASE, Cochrane Library, Web of science, China National Knowledge Infrastructure, Chinese biomedical literature service system, Wanfang Database, and VIP databases were systematically searched for studies on sepsis in China published before March 2, 2022. Random effects model was used to calculate pooled prevalence estimates with 95% confidence interval. Subgroup and sensitivity analyses were performed to address heterogeneity. Funnel plots and Egger's test were used to assess the publication bias.ResultsOverall, nine observational studies involving 324,020 Chinese patients (9,587 patients with sepsis) were analyzed. Four hospital-wide studies involving 301,272 patients showed pooled prevalence and mortality of 3.8% (95% CI: 2.9–4.7%, I2 = 99.9%) and 26% (95% CI: 16–36%, I2 = 98.0%), respectively. Five studies of ICU sepsis involving 22,748 patients presented pooled prevalence and mortality of 25.5% (95% CI: 13.9–37.0%, I2 = 99.8%) and 40% (95%CI: 34–47%, I2 = 95.9%), respectively. Subgroup analysis of sepsis in ICUs revealed that the pooled prevalence was higher among males [17% (95% CI 9–24%, I2 = 99.6%)], in lung infections [66% (95%CI: 54–77%, I2 = 98.7%)], and Gram-negative bacteria infections [37% (95%CI: 26–47%, I2 = 98.3%)]. The pooled prevalence of sepsis, severe sepsis and septic shock was 25.5% (95%CI: 13.9–37.0%, I2 = 99.8%), 19% (95%CI: 9–28%, I2 = 99.6%), and 13% (95%CI: 7–19%, I2 = 99.2%), respectively.ConclusionsSepsis is prevalent in 25.5% of ICU patients in China, and sex, sepsis severity, infection site, causative microorganism, and infection type are significant influencing factors. Larger trials are needed to evaluate the prevalence of sepsis in China, which may help the development of global strategies for sepsis management.Systematic review registrationPROSPERO, identifier: CRD42022314274.
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spelling doaj.art-d9787a8784c040aa9b078da01363468f2022-12-22T03:55:28ZengFrontiers Media S.A.Frontiers in Public Health2296-25652022-10-011010.3389/fpubh.2022.977094977094Prevalence of sepsis among adults in China: A systematic review and meta-analysisSiyuan Lei0Xuanlin Li1Xuanlin Li2Hulei Zhao3Yang Xie4Jiansheng Li5Jiansheng Li6Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, ChinaCo-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, ChinaCollege of Basic Medical Science, Institute of Basic Research in Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, ChinaDepartment of Respiratory Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, ChinaDepartment of Respiratory Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, ChinaCo-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, ChinaDepartment of Respiratory Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, ChinaBackgroundSepsis is a major public health problem that cannot be ignored in China and even in the world. However, the prevalence of sepsis in Chinese adults varies among different studies.ObjectiveTo evaluate the prevalence of hospital-wide sepsis and intensive care unit (ICU) sepsis in Chinese adults.MethodsPubMed, EMBASE, Cochrane Library, Web of science, China National Knowledge Infrastructure, Chinese biomedical literature service system, Wanfang Database, and VIP databases were systematically searched for studies on sepsis in China published before March 2, 2022. Random effects model was used to calculate pooled prevalence estimates with 95% confidence interval. Subgroup and sensitivity analyses were performed to address heterogeneity. Funnel plots and Egger's test were used to assess the publication bias.ResultsOverall, nine observational studies involving 324,020 Chinese patients (9,587 patients with sepsis) were analyzed. Four hospital-wide studies involving 301,272 patients showed pooled prevalence and mortality of 3.8% (95% CI: 2.9–4.7%, I2 = 99.9%) and 26% (95% CI: 16–36%, I2 = 98.0%), respectively. Five studies of ICU sepsis involving 22,748 patients presented pooled prevalence and mortality of 25.5% (95% CI: 13.9–37.0%, I2 = 99.8%) and 40% (95%CI: 34–47%, I2 = 95.9%), respectively. Subgroup analysis of sepsis in ICUs revealed that the pooled prevalence was higher among males [17% (95% CI 9–24%, I2 = 99.6%)], in lung infections [66% (95%CI: 54–77%, I2 = 98.7%)], and Gram-negative bacteria infections [37% (95%CI: 26–47%, I2 = 98.3%)]. The pooled prevalence of sepsis, severe sepsis and septic shock was 25.5% (95%CI: 13.9–37.0%, I2 = 99.8%), 19% (95%CI: 9–28%, I2 = 99.6%), and 13% (95%CI: 7–19%, I2 = 99.2%), respectively.ConclusionsSepsis is prevalent in 25.5% of ICU patients in China, and sex, sepsis severity, infection site, causative microorganism, and infection type are significant influencing factors. Larger trials are needed to evaluate the prevalence of sepsis in China, which may help the development of global strategies for sepsis management.Systematic review registrationPROSPERO, identifier: CRD42022314274.https://www.frontiersin.org/articles/10.3389/fpubh.2022.977094/fullsepsisChinaprevalencesystematic reviewmeta-analysis
spellingShingle Siyuan Lei
Xuanlin Li
Xuanlin Li
Hulei Zhao
Yang Xie
Jiansheng Li
Jiansheng Li
Prevalence of sepsis among adults in China: A systematic review and meta-analysis
Frontiers in Public Health
sepsis
China
prevalence
systematic review
meta-analysis
title Prevalence of sepsis among adults in China: A systematic review and meta-analysis
title_full Prevalence of sepsis among adults in China: A systematic review and meta-analysis
title_fullStr Prevalence of sepsis among adults in China: A systematic review and meta-analysis
title_full_unstemmed Prevalence of sepsis among adults in China: A systematic review and meta-analysis
title_short Prevalence of sepsis among adults in China: A systematic review and meta-analysis
title_sort prevalence of sepsis among adults in china a systematic review and meta analysis
topic sepsis
China
prevalence
systematic review
meta-analysis
url https://www.frontiersin.org/articles/10.3389/fpubh.2022.977094/full
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