Abstract：
OBJECTIVE: To analyze the epidemiological characteristics of hospitalized patients diagnosed with sepsis in a large class III general hospital in Southwest China in a period of 2 years, and to explore the risk factors related to death in patients with sepsis.
METHODS: A retrospective study was conducted to select patients with sepsis admitted to Sichuan Provincial People\'s Hospital from September 1, 2021 to August 31, 2023, and general characteristics such as gender, age, discharge diagnosis, discharge department, hospitalization cost, length of stay, and prognosis during hospitalization were collected. The baseline of two groups of patients was compared, and the risk factors of in-hospital cause of death in patients with sepsis were analyzed by multivariate Logistic regression.
RESULTS: A total of 3 568 patients with sepsis were included with median age of 58 (35, 74) years old. Of all patients, there were 2 147 males (60.17%). The median length of hospitalization was 13 (8, 24) days, and the median hospitalization cost was 3.98 (1.87, 8.83) ten thousand yuan. The departments with more than 100 cases of sepsis in 2 years were central intensive care unit (ICU), pediatrics department, nephrology department, emergency medicine department, emergency intensive care unit (EICU), infectious department, respiratory medicine department, hematology department, neonatal care unit and emergency surgical department. A total of 1 210 patients (33.91%) admitted to ICU (including central ICU and EICU). The hospitalization cost of ICU patients were higher [6.7 (3.1, 15.5) ten thousand yuan], the hospitalization duration was longer [9 (3, 17) days], and the mortality was higher [35.29% (427/1 210)]. Among 3 568 patients with sepsis, 448 died and 3 120 survived during hospitalization. The age, male proportion and hospitalization cost of patients with sepsis in the death group were significantly higher than those in the survival group [age (years old): 75 (60, 86) vs. 57 (30, 71), male proportion: 67.86% (304/448) vs. 59.07% (1 843/3 120), hospitalization cost (ten thousand yuan): 6.7 (3.0, 16.9) vs. 3.7 (1.8, 8.1)], the ratio of diabetes mellitus was significantly lower than that of survival group [4.91% (22/448) vs. 10.45% (326/3 120)], the length of hospitalization was shorter than that of survival group [days: 10.0 (3.0, 19.0) vs. 13.0 (8.0, 24.0)], the differences were statistically significant (all P < 0.01). Multivariate Logistic regression analysis showed that male [odds ratio (OR) = 0.75, 95% confidence interval (95%CI) was 0.59-0.96], elder (OR = 1.04, 95%CI was 1.03-1.05) and diabetes (OR = 0.32, 95%CI was 0.19-0.54) were independent risk factors for in-hospital death in patients with sepsis (all P < 0.05).
CONCLUSIONS: Sepsis is a heavy burden in Southwest China, especially for ICU, with high mortality, high hospitalization costs, and heavy economic burden on patients and society. Male, elder and diabetes were independent risk factors for in-hospital death of sepsis patients.
METHODS: A retrospective study was conducted to select patients with sepsis admitted to Sichuan Provincial People\'s Hospital from September 1, 2021 to August 31, 2023, and general characteristics such as gender, age, discharge diagnosis, discharge department, hospitalization cost, length of stay, and prognosis during hospitalization were collected. The baseline of two groups of patients was compared, and the risk factors of in-hospital cause of death in patients with sepsis were analyzed by multivariate Logistic regression.
RESULTS: A total of 3 568 patients with sepsis were included with median age of 58 (35, 74) years old. Of all patients, there were 2 147 males (60.17%). The median length of hospitalization was 13 (8, 24) days, and the median hospitalization cost was 3.98 (1.87, 8.83) ten thousand yuan. The departments with more than 100 cases of sepsis in 2 years were central intensive care unit (ICU), pediatrics department, nephrology department, emergency medicine department, emergency intensive care unit (EICU), infectious department, respiratory medicine department, hematology department, neonatal care unit and emergency surgical department. A total of 1 210 patients (33.91%) admitted to ICU (including central ICU and EICU). The hospitalization cost of ICU patients were higher [6.7 (3.1, 15.5) ten thousand yuan], the hospitalization duration was longer [9 (3, 17) days], and the mortality was higher [35.29% (427/1 210)]. Among 3 568 patients with sepsis, 448 died and 3 120 survived during hospitalization. The age, male proportion and hospitalization cost of patients with sepsis in the death group were significantly higher than those in the survival group [age (years old): 75 (60, 86) vs. 57 (30, 71), male proportion: 67.86% (304/448) vs. 59.07% (1 843/3 120), hospitalization cost (ten thousand yuan): 6.7 (3.0, 16.9) vs. 3.7 (1.8, 8.1)], the ratio of diabetes mellitus was significantly lower than that of survival group [4.91% (22/448) vs. 10.45% (326/3 120)], the length of hospitalization was shorter than that of survival group [days: 10.0 (3.0, 19.0) vs. 13.0 (8.0, 24.0)], the differences were statistically significant (all P < 0.01). Multivariate Logistic regression analysis showed that male [odds ratio (OR) = 0.75, 95% confidence interval (95%CI) was 0.59-0.96], elder (OR = 1.04, 95%CI was 1.03-1.05) and diabetes (OR = 0.32, 95%CI was 0.19-0.54) were independent risk factors for in-hospital death in patients with sepsis (all P < 0.05).
CONCLUSIONS: Sepsis is a heavy burden in Southwest China, especially for ICU, with high mortality, high hospitalization costs, and heavy economic burden on patients and society. Male, elder and diabetes were independent risk factors for in-hospital death of sepsis patients.
摘要：
目的：分析西南地区某大型三级综合医院2年诊断为脓毒症的住院患者的流行病学特征。探讨脓毒症患者死亡的相关危险因素。
方法：对2021年9月1日至2023年8月31日四川省人民医院收治的脓毒症患者进行回顾性研究，并以性别、年龄,放电诊断,出院部门，住院费用，逗留时间,收集住院期间的预后。比较两组患者的基线,采用多因素Logistic回归分析脓毒症患者院内死亡原因的危险因素。
结果：共纳入3568例脓毒症患者，中位年龄为58岁（35,74）。在所有患者中，男性2147人(60.17%)。住院时间中位数为13（8，24）天，住院费用中位数为3.98（1.87，8.83）万元。2年内发生脓毒症100例以上的科室为中心重症监护病房(ICU),儿科,肾脏科,急诊医学部,急诊重症监护病房(EICU),感染科,呼吸内科,血液科,新生儿监护病房和急诊外科。共有1210例(33.91%)入住ICU(包括中央ICU和EICU)。ICU患者住院费用较高[6.7(3.1、15.5)万元]，住院时间较长[9（3，17）天]，死亡率较高[35.29%(427/1210)]。在3568例脓毒症患者中，住院期间死亡448人，存活3120人。年龄,死亡组败血症患者的男性比例和住院费用明显高于存活组[年龄（岁）：75（60，86）vs.57(30,71),男性比例：67.86%（304/448）59.07%（1843/3120），住院费用（万元）：6.7（3.0，16.9）vs.3.7(1.8,8.1)],糖尿病的比率明显低于生存组[4.91%(22/448)。10.45%（326/3120）]，住院时间短于生存组[天数：10.0（3.0，19.0）vs.13.0（8.0，24.0）]，差异均有统计学意义(均P<0.01)。多因素Logistic回归分析显示,男性[比值比(OR)=0.75,95%置信区间(95CI)为0.59-0.96],老年（OR=1.04，95CI为1.03~1.05）和糖尿病（OR=0.32，95CI为0.19~0.54）是脓毒症患者院内死亡的独立危险因素（均P<0.05）。
结论：脓毒症在中国西南地区是一个沉重的负担，尤其是ICU,死亡率高，高昂的住院费用，给患者和社会带来沉重的经济负担。男性,老年和糖尿病是脓毒症患者院内死亡的独立危险因素。
方法：对2021年9月1日至2023年8月31日四川省人民医院收治的脓毒症患者进行回顾性研究，并以性别、年龄,放电诊断,出院部门，住院费用，逗留时间,收集住院期间的预后。比较两组患者的基线,采用多因素Logistic回归分析脓毒症患者院内死亡原因的危险因素。
结果：共纳入3568例脓毒症患者，中位年龄为58岁（35,74）。在所有患者中，男性2147人(60.17%)。住院时间中位数为13（8，24）天，住院费用中位数为3.98（1.87，8.83）万元。2年内发生脓毒症100例以上的科室为中心重症监护病房(ICU),儿科,肾脏科,急诊医学部,急诊重症监护病房(EICU),感染科,呼吸内科,血液科,新生儿监护病房和急诊外科。共有1210例(33.91%)入住ICU(包括中央ICU和EICU)。ICU患者住院费用较高[6.7(3.1、15.5)万元]，住院时间较长[9（3，17）天]，死亡率较高[35.29%(427/1210)]。在3568例脓毒症患者中，住院期间死亡448人，存活3120人。年龄,死亡组败血症患者的男性比例和住院费用明显高于存活组[年龄（岁）：75（60，86）vs.57(30,71),男性比例：67.86%（304/448）59.07%（1843/3120），住院费用（万元）：6.7（3.0，16.9）vs.3.7(1.8,8.1)],糖尿病的比率明显低于生存组[4.91%(22/448)。10.45%（326/3120）]，住院时间短于生存组[天数：10.0（3.0，19.0）vs.13.0（8.0，24.0）]，差异均有统计学意义(均P<0.01)。多因素Logistic回归分析显示,男性[比值比(OR)=0.75,95%置信区间(95CI)为0.59-0.96],老年（OR=1.04，95CI为1.03~1.05）和糖尿病（OR=0.32，95CI为0.19~0.54）是脓毒症患者院内死亡的独立危险因素（均P<0.05）。
结论：脓毒症在中国西南地区是一个沉重的负担，尤其是ICU,死亡率高，高昂的住院费用，给患者和社会带来沉重的经济负担。男性,老年和糖尿病是脓毒症患者院内死亡的独立危险因素。
