据估计,全球每年约有 3150 万人患脓毒症,每年致死病例约为 530 万。[4]Fleischmann C, Scherag A, Adhikari NK, et al. Assessment of Global Incidence and Mortality of Hospital-treated Sepsis. Current Estimates and Limitations. Am J Respir Crit Care Med. 2016 Feb 1;193(3):259-72.http://www.atsjournals.org/doi/full/10.1164/rccm.201504-0781OChttp://www.ncbi.nlm.nih.gov/pubmed/26414292?tool=bestpractice.com 脓毒症的人群发病率估计高达每年 100,000人中 176 至 380 例。[5]Martin GS, Mannino DM, Eaton S, et al. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med. 2003 Apr 17;348(16):1546-54.http://www.nejm.org/doi/full/10.1056/NEJMoa022139#t=articlehttp://www.ncbi.nlm.nih.gov/pubmed/12700374?tool=bestpractice.com[6]Angus DC, Wax RS. Epidemiology of sepsis: an update. Crit Care Med. 2001 Jul;29(suppl 7):S109-16.http://www.ncbi.nlm.nih.gov/pubmed/11445744?tool=bestpractice.com[7]Karlsson S, Varpula M, Ruokonen E. Incidence, treatment, and outcome of severe sepsis in ICU-treated adults in Finland: the Finnsepsis Study. Intensive Care Med. 2007 Mar;33(3):435-43.http://www.ncbi.nlm.nih.gov/pubmed/17225161?tool=bestpractice.com[8]Blanco J, Muriel-Bombin A, Sagredo V, et al. Incidence, organ dysfunction and mortality in severe sepsis: a Spanish multicentre study. Crit Care. 2008;12(6):R158.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2646323/http://www.ncbi.nlm.nih.gov/pubmed/19091069?tool=bestpractice.com 在欧洲,脓毒症的每年发病率约为 90.4/10 万。[9]Davies A, Green C, Hutton J. 581 Severe sepsis: a European estimate of the burden of disease in ICU [oral presentation abstract from 14th Annual Congress of the European Society of Intensive Care Medicine, Geneva, Switzerland, 30 September-3 October 2001]. Intensive Care Medicine. 2001;27(suppl 2):S284. 然而,发病率的高低取决于对脓毒症的定义。加拿大的发病率为每年每 100,000 人中有 15.7 例需要进入重症监护病房jieshou 治疗。[10]Laupland KB, Gregson DB, Zygun DA, et al. Severe bloodstream infections: a population-based assessment. Crit Care Med. 2004 Apr;32(4):992-7.http://www.ncbi.nlm.nih.gov/pubmed/15071391?tool=bestpractice.com
脓毒症的发病率可能仍会不断攀升。在英格兰,2015 年英国健康与社会保健信息中心 (HSCIC) 发布的来自医院发病统计 (Hospital Episode Statistics) 的数据显示,在 2013/14 年度,有接近 123,000 例脓毒症,相关死亡病例有 36,800 例。[11]Health and Social Care Information Centre. Sepsis annual data inpatient measures. 2015 [internet publication].而此数据在 2010 年时大约为 2.51 万例。[12]McPherson D, Griffiths C, Williams M, et al. Sepsis-associated mortality in England: an analysis of multiple cause of death data from 2001 to 2010. BMJ Open. 2013 Aug 2;3(8).http://bmjopen.bmj.com/content/3/8/e002586http://www.ncbi.nlm.nih.gov/pubmed/23913771?tool=bestpractice.com 然而,在进一步回顾 HSCIC 的数据后,重新估算的英格兰脓毒症病例数高达 260,000 例。[13]York Health Economics Consortium. The cost of sepsis care in the UK: final report. February 2017 [internet publication].http://allcatsrgrey.org.uk/wp/download/health_economics/YHEC-Sepsis-Report-17.02.17-FINAL.pdf
大多数流行病学研究发现,男性比女性的脓毒症患病率高。65 岁以上的老年人尤其易患病,其中一项研究表明,将近 2/3 的患者为 65 岁以上。[14]Martin GS, Mannino DM, Moss M. The effect of age on the development and outcome of adult sepsis. Crit Care Med. 2006 Jan;34(1):15-21.http://www.ncbi.nlm.nih.gov/pubmed/16374151?tool=bestpractice.com