Trends in the incidence and outcomes of sepsis using a Japanese nationwide database were investigated. This was a retrospective cohort study. Adult patients, who had both presumed serious infections and acute organ dysfunction, between 2010 and 2017 were extracted using a combined method of administrative and electronic health record data from the Japanese nationwide medical claim database, which covered 71.5% of all acute care hospitals in 2017. Presumed serious infection was defined using blood culture test records and antibiotic administration. Acute organ dysfunction was defined using records of diagnosis according to the international statistical classification of diseases and related health problems, 10th revision, and records of organ support. The primary outcomes were the annual incidence of sepsis and death in sepsis per 1000 inpatients. The secondary outcomes were in-hospital mortality rate and length of hospital stay in patients with sepsis. The analyzed dataset included 50,490,128 adult inpatients admitted between 2010 and 2017. Of these, 2,043,073 (4.0%) patients had sepsis. During the 8-year period, the annual proportion of patients with sepsis across inpatients significantly increased (slope = + 0.30%/year, P < 0.0001), accounting for 4.9% of the total inpatients in 2017. The annual death rate of sepsis per 1000 inpatients significantly increased (slope = + 1.8/1000 inpatients year, P = 0.0001), accounting for 7.8 deaths per 1000 inpatients in 2017. The in-hospital mortality rate and median (interquartile range) length of hospital stay significantly decreased (P < 0.001) over the study period and were 18.3% and 27 (15–50) days in 2017, respectively. The Japanese nationwide data indicate that the annual incidence of sepsis and death in inpatients with sepsis significantly increased; however, the annual mortality rates and length of hospital stay in patients with sepsis significantly decreased. The increasing incidence of sepsis and death in sepsis appear to be a significant and ongoing issue.

中文翻译：

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使用来自日本全国医疗索赔数据库的数据——日本脓毒症联盟 (JaSA) 研究组——的脓毒症发病率和结果趋势

使用日本全国数据库调查了败血症的发生率和结果的趋势。这是一项回顾性队列研究。使用行政和电子健康记录数据相结合的方法从日本全国医疗索赔数据库中提取了2010年至2017年期间被推定为严重感染和急性器官功能障碍的成年患者，该数据库覆盖了2017年所有急症护理医院的71.5% . 假定的严重感染是使用血培养测试记录和抗生素给药来定义的。急性器官功能障碍是根据国际疾病和相关健康问题统计分类第 10 版的诊断记录和器官支持记录定义的。主要结果是每 1000 名住院患者中败血症的年发生率和败血症死亡率。次要结果是脓毒症患者的住院死亡率和住院时间。分析的数据集包括 2010 年至 2017 年间入院的 50,490,128 名成年住院患者。其中，2,043,073 (4.0%) 名患者患有败血症。8年间，每年住院患者中脓毒症患者比例显着增加（斜率=+0.30%/年，P<0.0001），占2017年住院患者总数的4.9%。 1000 名住院患者显着增加（斜率 = + 1.8/1000 名住院患者年，P = 0.0001），占 2017 年每 1000 名住院患者死亡 7.8 人。 0.001) 在研究期间分别为 18.3% 和 27 (15-50) 天，2017 年。日本全国数据显示，脓毒症住院患者的脓毒症年发病率和死亡率显着增加；然而，脓毒症患者的年死亡率和住院时间显着降低。脓毒症中脓毒症和死亡的发病率不断增加似乎是一个重要且持续的问题。