Bacterial Sepsis in Brazilian Children A Trend Analysis from 1992 to 2006 英文参考文献.docVIP

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Bacterial Sepsis in Brazilian Children A Trend Analysis from 1992 to 2006 英文参考文献.doc

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Bacterial Sepsis in Brazilian Children A Trend Analysis from 1992 to 2006 英文参考文献

BacterialSepsisinBrazilianChildren:ATrendAnalysis from1992to2006 CristinaMalzoniFerreiraMangia1,NiranjanKissoon2*,OtavioAugustoBranchini3,MariaCristina Andrade1,BenjaminIsraelKopelman1,JoeCarcillo4 1Department of Pediatrics, Universidade Federal de Sa?o Paulo Escola Paulista de Medicina, Sa?o Paulo, Brazil, 2Division of Critical Care, Department of Pediatrics, UniversityofBritishColumbia,ChildandFamilyResearchInstitute,Vancouver,Canada,3HospitalEmilioRibas,Sa?o Paulo,Brazil,4DepartmentofAnesthesiologyand CriticalCareMedicine,UniversityofPittsburghSchoolofMedicine,UniversityofPittsburgh,Pittsburgh,Pennsylvania,UnitedStatesofAmerica Abstract Background:TheobjectiveofthisstudywastodeterminetheepidemiologyofhospitalizedpediatricsepsisinBrazil(1992– 2006)andtocomparemortalitycausedbysepsistothatcausedbyothermajorchildhooddiseases. Methods and Findings: We performed a retrospective descriptive study of hospital admissions using a government databaseofallhospitalaffiliatedwiththeBrazilianhealthsystem.Westudiedallhospitalizationsinchildrenfrom28days through19yearswithdiagnosisofbacterialsepsisdefinedbythecriteriaoftheInternationalClassificationofDiseases(ICD), (AppendixS1).Basedonthedatastudiedfrom1992through2006,thepediatrichospitalmortalityratewas1.23%andthere were556,073pediatricadmissionswithbacterialsepsiswithameanmortalityrateof19.9%.Therewasacasereductionof 67%over.1992–2006(p,0.001);however,themortalityrateremainedunchanged(from1992–1996,20.5%;andfrom2002– 2006, 19.7%). Sepsis-hospital mortality rate was substantially higher than pneumonia (0.5%), HIV (3.3%), diarrhea (0.3%), undernutrition(2.3%),malaria(0.2%)andmeasles(0.7%).Thehumandevelopmentindex(HDI)andmortalityrates(MR)by regionwere:Northregion0.76and21.7%;Northeastregion0.72and27.1%;Central-West0.81and23.5%;Southregion0.83 and12.2%andSoutheastregion0.82and14.8%,respectively. Conclusions: We concluded that sepsis remains an important health problem in children in Brazil. The institution of universal