Evolving Trends in the Epidemiology, Resource Utilization, and Outcomes of Pregnancy-Associated Severe Sepsis: A Population-Based Cohort Study

摘要: Background: Infections are a well-known complication of pregnancy. However, pregnancy-associated severe sepsis (PASS) has not been as well-characterized, with limited population-level data reported to date. We performed population-based study the evolving patterns epidemiology, clinical characteristics, resource utilization, and outcomes PASS in Texas over past decade. Methods: The Inpatient Public Use Data File was used identify hospitalizations for years 2001 - 2010. Center Health Statistics reports live births, abortions fetal deaths, previously population-based, age-specific linkage on miscarriage were derive annual total estimated pregnancies (TEPs). incidence, demographics, utilization examined. Logistic regression modeling explore predictors its associated mortality. Results: There 4,060,201 1,007 during period. incidence increased by 236% decade, rising from 11 26 per 100,000 TEPs. key changes between 2002 2009 2010 within included: admission ICU 78% vs. 90% (P = 0.002); development ≥ 3 organ failures 9% 35% < 0.0001); inflation-adjusted median hospital charges (2,010 dollars) $64,034 $89,895 0.0141). Hospital mortality (11%) remained unchanged Chronic liver disease (adjusted odds ratio (aOR) 41.4) congestive heart failure (CHF) (aOR 20.5) highest risk PASS, addition black race, poverty, drug abuse, lack health insurance. death among women HIV infection 45.5), need mechanical ventilation 4.5), abuse 3.0), lacking insurance 2.9). Conclusions: severity, fiscal burden rose substantially Case fatality lower than that general population. CHF pose especially high PASS. Pregnant history at both developing dying requiring extra vigilance early diagnosis targeted intervention. J Clin Med Res. 2015;7(6):400-416 doi: http://dx.doi.org/10.14740/jocmr2118w