Shock in China 2018 (SIC-study): a cross-sectional survey

Longxiang Su; Xudong Ma; Xi Rui; Huaiwu He; Ye Wang; Guangliang Shan; Yan Kang; You Shang; Ruiqiang Zheng; Shusheng Li; Qingyuan Zhan; Renyu Ding; Yongjie Yin; Li Jiang; Lina Zhang; Qinggang Ge; Liu Zhang; Junyu Lu; Linjun Wan; Jing Yan; Dawei Liu; Yun Long; Xiangdong Guan; Dechang Chen; Xiang Zhou; Shuyang Zhang

doi:10.21037/atm-21-310

Shock in China 2018 (SIC-study): a cross-sectional survey

Ann Transl Med. 2021 Aug;9(15):1219. doi: 10.21037/atm-21-310.

Authors

Longxiang Su¹, Xudong Ma², Xi Rui¹, Huaiwu He¹, Ye Wang³, Guangliang Shan³, Yan Kang⁴, You Shang⁵, Ruiqiang Zheng⁶, Shusheng Li⁷, Qingyuan Zhan⁸, Renyu Ding⁹, Yongjie Yin¹⁰, Li Jiang¹¹, Lina Zhang¹², Qinggang Ge¹³, Liu Zhang¹⁴, Junyu Lu¹⁵, Linjun Wan¹⁶, Jing Yan¹⁷, Dawei Liu¹, Yun Long¹, Xiangdong Guan¹⁸, Dechang Chen¹⁹, Xiang Zhou¹, Shuyang Zhang²⁰

Affiliations

¹ Department of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China.
² Department of Medical Administration, National Health Commission of the People's Republic of China, Beijing, China.
³ Department of Epidemiology and Biostatistics, Institute of Basic Medicine Sciences, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China.
⁴ Department of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China.
⁵ Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁶ Department of Critical Care Medicine, Northern Jiangsu People's Hospital, Yangzhou, China.
⁷ Department of Critical Care Medicine, Tongji Hospital affiliated to Tongji Medical College Huazhong University of Science and Technology, Wuhan, China.
⁸ Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China.
⁹ Department of Critical Care Medicine, The First Hospital of China Medical University, Shenyang, China.
¹⁰ Department of Emergency and Critical Care Medicine, The Second Hospital of Jilin University, Changchun, China.
¹¹ Department of Critical Care Medicine, Xuanwu Hospital Capital Medical University, Beijing, China.
¹² Department of Critical Care Medicine, Xiangya Hospital, Changsha, China.
¹³ Department of Critical Care Medicine, Zhejiang Hospital, Hangzhou, China.
¹⁴ Department of Critical Care Medicine, Peking University Third Hospital, Beijing, China.
¹⁵ Department of Critical Care Medicine, Peking University People's Hospital, Beijing, China.
¹⁶ Department of Critical Care Medicine, Guangxi Medical University Affiliated Hospital, Nanning, China.
¹⁷ Department of Critical Care Medicine, Zhejiang Medical University Affiliated Hospital, Hangzhou, China.
¹⁸ Department of Critical Care Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
¹⁹ Department of Critical Care Medicine, Ruijin Hospital affiliated to Medical College of Shanghai Jiaotong University, Shanghai, China.
²⁰ Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China.

Abstract

Background: Shock is a critical illness that seriously threatens the lives of patients. This study explains the epidemiology of shock, mortality of shock, and identify factors that related to hospital death.

Methods: This is a multi-centre cross-sectional survey, which included 1,064 tertiary hospitals in 31 provinces, municipalities, and autonomous regions across China mainland. Totally 289,428 patients who diagnosed with shock based on the ICD-10 abstracted from the Hospital Quality Monitoring System (HQMS) in 2018, a national database administrated by National Health Commission of the PRC.

Results: Patients diagnosed with shock were screened and classified according to the type of shock. Regression analysis was used to identify factors that related to death. A total of 79,668,156 medical records were included in HQMS in 2018, from which a total of 289,428 records with shock were identified. Hypovolemic shock occurred in 128,436 cases (44.38%), septic shock occurred in 121,543 cases (41.99%), cardiogenic shock occurred in 44,597 cases (15.41), and obstructive shock occurred in 3,168 cases (1.09%). Of these, 8,147 cases (2.81%) had mixed shock, which means had two or more types of shock. For all the shock cases, the top three frequent concomitant diseases recorded were circulatory system diseases (55.22%), digestive system diseases (53.64%), and respiratory system diseases (53.31%). Of the four types of shock, cases with cardiogenic shock had the highest in-hospital mortality (31.6%), followed by those with obstructive shock (25.2%), septic shock (22.9%), and hypovolemic shock (15.5%). Interestingly, the combination of shock and malignant tumors is one of the major factors that related to hospital deaths.

Conclusions: Shock is a serious disease with a high fatality rate and huge clinical costs. According to this epidemiological survey of shock in China 2018, we should clarify the factors related to the hospital death in shock cases.

Keywords: Hospital Quality Monitoring System (HQMS); Shock; epidemiology; outcome; risk factor.