Epidemiology and Mortality of Sepsis in Intensive Care Units in Prefecture-Level Cities in Sichuan, China: A Prospective Multicenter Study

Abstract

Background Studies on the epidemiology of sepsis in intensive care units (ICUs) of prefecture-level hospitals in China are rare. This study aimed to investigate the epidemiological characteristics and mortality risk factors of sepsis in ICUs of tertiary hospitals in Sichuan, China. Material/Methods In this prospective, multicenter, observational study, patients admitted to the ICU of 7 tertiary hospitals in Sichuan (China) between October 10, 2017 and January 9, 2018 were screened for sepsis using the Sepsis-3 criteria. Patients with sepsis were included. Results Of the 1604 patients screened for sepsis, 294 (18.3%) had sepsis, and 140 (47.6%) had septic shock. Of these, 169 (57.5%) died. Multivariable analysis showed that central nervous system dysfunction (odds ratio [OR]=2.59, 95% confidence interval [CI]: 1.15–5.84, P=0.022), lowest blood phosphorus level (OR=2.56, 95% CI: 1.21–5.44, P=0.014), highest lactate level (OR=1.20, 95% CI: 1.10–1.32, P<0.001), 24-h Acute Physiologic Assessment and Chronic Health Evaluation-II (APACHE-II) score (OR=1.08, 95% CI: 1.03–1.13, P=0.002), and lung infection (OR=2.57, 95% CI: 1.30–5.09, P=0.007) were independently associated with mortality in patients with sepsis. Conclusions The prevalence and mortality rates of sepsis are high in tertiary hospital ICUs in Sichuan, China. The APACHE-II score on day 1 after diagnosis, acute central nervous system dysfunction, lowest blood phosphorus, high serum lactate, and lung infection were independent risk factors of mortality in patients with sepsis.

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

“…Eight studies were published in English-language journals, while one study was in a Chinese-language journal. Of the nine studies, four ( 17 , 20 , 21 , 25 ) were conducted in hospital-wide, and five ( 18 , 19 , 22 – 24 ) were conducted in ICUs. In addition, four ( 17 , 20 , 21 , 25 ) studies were retrospective in design, four ( 18 , 19 , 22 , 24 ) were prospective, and one ( 23 ) was a cross-section survey.…”

“…Of the nine studies, four ( 17 , 20 , 21 , 25 ) were conducted in hospital-wide, and five ( 18 , 19 , 22 – 24 ) were conducted in ICUs. In addition, four ( 17 , 20 , 21 , 25 ) studies were retrospective in design, four ( 18 , 19 , 22 , 24 ) were prospective, and one ( 23 ) was a cross-section survey. The mean age of patients ranged from 36.8 years to 81 years.…”

Potential of circulating lncRNA CASC2 as a biomarker in reflecting the inflammatory cytokines, multi‐organ dysfunction, disease severity, and mortality in sepsis patients

“…Sepsis is symbolized by the systemic inflammatory response and multi‐organ failure; globally, there are about 49 million sepsis patients each year, of which 11 million patients die from sepsis 1 , 2 , 3 . In China, sepsis is also a prevalent infectious disease; it has been reported that among every 100 patients in the intensive care unit, there are 21 sepsis cases, whose mortality rate within 90 days has reached nearly 36% 4 , 5 . Apart from these, complications contributed by sepsis, including acute kidney injury (AKI), acute lung injury (ALI), disseminated intravascular coagulation, etc., are crucial causes of poor prognosis in sepsis patients 6 , 7 , 8 , 9 .…”

“…In China, sepsis is also a prevalent infectious disease; it has been reported that among every 100 patients in the intensive care unit, there are 21 sepsis cases, whose mortality rate within 90 days has reached nearly 36% 4,5 . Apart from these, complications contributed by sepsis, including acute kidney injury (AKI), acute lung injury (ALI), disseminated intravascular coagulation, etc., are crucial causes of poor prognosis in sepsis patients [6][7][8][9] .…”

Toll-like receptor 4-mediated endoplasmic reticulum stress induces intestinal paneth cell damage in mice following CLP-induced sepsis

“…In 2021, a study from Sichuan province reported that the current situation of sepsis treatment in western China. The mortality rate of sepsis patients was as high as 57.5% 5 , and the per capita hospitalization cost reached 11,390 dollars. Thus, sepsis was a global public health problem, killing more than 5 million people worldwide every year, which was a major economic burden for patients and society.…”