隐形疾病可能会导致全球20%的死亡

隐形疾病可能会导致全球20%的死亡

A medical condition that often escapes public notice may be involved in 20% of deaths worldwide, according to a new study.

根据一项新的研究，一种经常不被公众注意的疾病可能导致了全世界20%的死亡。

The disease is sepsis — sometimes called blood poisoning. It arises when the body overreacts to an infection. Blood vessels throughout the body become leaky, triggering multiple-organ failure.

这种疾病是败血症，有时也称为血液中毒。当身体对感染反应过度时，它就会出现。全身的血管开始渗漏，引发多器官衰竭。

It is surprisingly common in the United States: One prominent study estimates 1.7 million cases a year and 270.000 deaths. Sepsis in the U.S. can strike otherwise healthy people who get an infection that runs amok. Many other cases arise in the hospital. That occurs frequently in people who are already in poor health.

这在美国非常普遍:一项著名的研究估计每年有170万病例，27万人死亡。在美国，败血症可能会感染其他方面健康的人，而这些人会被感染得很严重。医院里还有许多其他的病例。这种情况经常发生在健康状况不佳的人身上。

"Often the underlying cause is something like lung cancer," says Dr. Kristina Rudd, the lead author of a study published Thursday in the Lancet. Those people may develop pneumonia, which in turn leads to a deadly case of sepsis. With this domino effect, "It can be really hard to sort that out," she says.

周四发表在《柳叶刀》杂志上的一项研究的主要作者克里斯蒂娜·路德博士说:“通常潜在的原因是肺癌之类的疾病。”这些人可能会患上肺炎，从而导致致命的败血症。她说，由于这种多米诺骨牌效应，“很难解决这个问题”。

It's an even bigger problem in the developing world, where childbearing women are at the greatest risk. "These are women who develop an infection after they give birth or have a C-section," Rudd says. These women may develop an infection that triggers deadly sepsis, "because often they don't have access to appropriate obstetric care."

在发展中国家，这是一个更大的问题，那里的育龄妇女面临的风险最大。拉德说:“这些妇女在分娩或剖腹产后出现感染。这些妇女可能会感染上致命的败血症，“因为她们通常无法获得适当的产科护理。”

Previous studies have suggested that sepsis is at least partly responsible for 1 in 10 deaths globally. Rudd — an assistant professor of critical care medicine at the University of Pittsburgh — along with more than a dozen collaborators, including some at the University of Washington, decided to look more closely at sepsis globally.

以前的研究表明，败血症是全球至少1 / 10的死亡的部分原因。拉德是匹兹堡大学危重症医学的助理教授，他和包括华盛顿大学在内的十几位合作者决定在全球范围内更仔细地研究败血症。

They analyzed more than 100 million death certificates, dated between 1990 and 2007. They found that sepsis is twice as common as health officials have long believed, if not as a direct cause of death, then at least as a contributing factor.

他们分析了1990年至2007年间超过1亿份死亡证明。他们发现，败血症的发病率是卫生官员长期以来所认为的两倍，如果它不是直接导致死亡的原因，那么至少是一个促成因素。

They estimate that about 11 million people worldwide died with sepsis in 2017 alone — out of 56 million total deaths. That's about 20% of all deaths. It's a massive number.

他们估计，仅在2017年，全世界就有1100万人死于败血症，死亡总数为5600万人。这大约占所有死亡人数的20%。这是一个巨大的数字。

There's also good news in this study: It documents major reductions in sepsis since 1990.

这项研究也有好消息:它记录了自1990年以来败血症的显著减少。

According to the paper, which was presented at a meeting today in Belfast, Northern Ireland, the death rate from sepsis has dropped by about half since 1990.

根据今天在北爱尔兰贝尔法斯特举行的会议上发表的论文，败血症的死亡率自1990年以来下降了大约一半。

That's a surprising finding, says Dr. Chanu Rhee, who studies sepsis and infectious disease at Harvard Medical School. "It's really interesting that in their study, they actually found the incidence of sepsis declined over the study period," he says, "where other studies have actually suggested the opposite."

哈佛医学院研究败血症和传染病的查理博士说，这是一个令人惊讶的发现。“有趣的是，在他们的研究中，他们发现败血症的发病率在研究期间下降了，”他说，“而其他研究的结果恰恰相反。”

Sepsis is not easy to study, in part because doctors may not think to include it as a cause of death or as a contributing factor on a death certificate.

败血症不容易研究，部分原因是医生可能不认为它是一种死亡原因或死亡证明上的一个促成因素。