Community-onset sepsis and its public health burden: a systematic review
| Autor: | Jennifer Cooper, Pamela Royle, Noel D. McCarthy, Alexander Tsertsvadze, Rebecca Crosby, Farah Seedat |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Lung Diseases
medicine.medical_specialty Medicine (miscellaneous) Body Mass Index Sepsis Cohort Studies 03 medical and health sciences Immunocompromised Host Peripheral Arterial Disease 0302 clinical medicine Sex Factors Residence Characteristics Risk Factors Internal medicine Community-onset sepsis medicine Odds Ratio Humans 030212 general & internal medicine Incidence of sepsis or severe sepsis Intensive care medicine Australasia business.industry Septic shock Incidence (epidemiology) Research Smoking Absolute risk reduction Case-control study Age Factors 030208 emergency & critical care medicine Odds ratio medicine.disease Shock Septic Nursing Homes Community-Acquired Infections Europe Case-Control Studies Cohort North America Public Health Hydroxymethylglutaryl-CoA Reductase Inhibitors Sedentary Behavior business Cohort study RC |
| Zdroj: | Systematic Reviews |
| ISSN: | 2046-4053 |
| Popis: | Background Sepsis is a life-threatening condition and major contributor to public health and economic burden in the industrialised world. The difficulties in accurate diagnosis lead to great variability in estimates of sepsis incidence. There has been even greater uncertainty regarding the incidence of and risk factors for community-onset sepsis (COS). We systematically reviewed the recent evidence on the incidence and risk factors of COS in high income countries (North America, Australasia, and North/Western Europe). Methods Cohort and case-control studies were eligible for inclusion. Medline and Embase databases were searched from 2002 onwards. References of relevant publications were hand-searched. Two reviewers screened titles/abstracts and full-texts independently. One reviewer extracted data and appraised studies which were cross-checked by independent reviewers. Disagreements were resolved via consensus. Odds ratios (ORs) and 95 percent confidence intervals (95 % CIs) were ascertained by type of sepsis (non-severe, severe, and septic shock). Results Ten cohort and 4 case-control studies were included. There was a wide variation in the incidence (# cases per 100,000 per year) of non-severe sepsis (range: 64–514), severe sepsis (range: 40–455), and septic shock (range: 9–31). Heterogeneity precluded statistical pooling. Two cohort and 4 case-control studies reported risk factors for sepsis. In one case-control and one cohort study, older age and diabetes were associated with increased risk of sepsis. The same case-control study showed an excess risk for sepsis in participants with clinical conditions (e.g., immunosuppression, lung disease, and peripheral artery disease). In one cohort study, higher risk of sepsis was associated with being a nursing home resident (OR = 2.60, 95 % CI: 1.20, 5.60) and in the other cohort study with being physically inactive (OR = 1.33, 95 % CI: 1.13, 1.56) and smoking tobacco (OR = 1.85, 95 % CI: 1.54, 2.22). The evidence on sex, ethnicity, statin use, and body mass index as risk factors was inconclusive. Conclusions The lack of a valid standard approach for defining sepsis makes it difficult to determine the true incidence of COS. Differences in case ascertainment contribute to the variation in incidence of COS. The evidence on COS is limited in terms of the number and quality of studies. This review highlights the urgent need for an accurate and standard method for identifying sepsis. Future studies need to improve the methodological shortcomings of previous research in terms of case definition, identification, and surveillance practice. Systematic review registration PROSPERO CRD42015023484 Electronic supplementary material The online version of this article (doi:10.1186/s13643-016-0243-3) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|