Updated Estimates of Sepsis Hospitalizations at United States Academic Medical Centers

Authors

Hei Kit Chan
Swapnil Khose
Summer Chavez
Bela Patel
Henry E Wang

Language

English

Publication Date

8-1-2022

Journal

Journal of the American College of Emergency Physicians Open

DOI

10.1002/emp2.12782

PMID

35859855

PMCID

PMC9288236

PubMedCentral® Posted Date

7-16-2022

PubMedCentral® Full Text Version

Post-print

Abstract

Objective: Sepsis is a major public health problem. Understanding the epidemiology of sepsis subtypes is important to quantify the magnitude of the problem and identify targets for system wide treatment strategies. We sought to describe the current national epidemiology of community-acquired (CAS), hospital-acquired (HAS) and healthcare-associated sepsis (HCAS) hospitalizations among academic medical centers in the United States using current discharge diagnosis taxonomies.

Methods: Retrospective analysis of patient discharge data from the Vizient Clinical Data Base/Resource Manager. We identified sepsis hospitalizations using four ICD-10 coding strategies: (1) "Martin" sepsis codes (21 ICD-10 codes), (2) "Angus" sepsis codes (ICD-10 infection + ICD-10 organ dysfunction), (3) Medicare "SEP-1" codes (28 ICD-10 codes), and (4) "explicit sepsis" codes (ICD-10 R65.20 and R65.21). Using present-on-admission flags for each diagnosis, we also distinguished: (1) community-acquired sepsis (CAS), (2) hospital-acquired sepsis (HAS), and (3) healthcare associated sepsis (HCAS).

Results: Among 22,655,240 hospitalizations, the number and incidence of sepsis hospitalizations were: (1) Martin (n = 1,718,257, 75.8 per 1000 hospitalizations), (2) Angus (n = 2,749,163, 121.3 per 1000), (3) SEP-1 (n = 1,624,909, 71.7 per 1000), and (4) explicit sepsis (n = 655,853, 28.9 per 1000). CAS was the most common sepsis subtype. HAS exhibited higher adjusted mortality than CAS. ICU admission was highest for HAS (Martin, 1.5%; Angus, 1.5%; SEP-1, 1.6%; Explicit, 1.9%).

Conclusions: These results illustrate the prevalence of sepsis at US academic medical centers using the most current sepsis classification taxonomies and discharge diagnosis codes. These results highlight important considerations when using hospital discharge data to characterize the epidemiology of sepsis.

Keywords

administrative data, discharge diagnoses, epidemiology, sepsis

Published Open-Access

yes

Recommended Citation

Chan, Hei Kit; Khose, Swapnil; Chavez, Summer; et al., "Updated Estimates of Sepsis Hospitalizations at United States Academic Medical Centers" (2022). Faculty, Staff and Student Publications. 705.
https://digitalcommons.library.tmc.edu/uthmed_docs/705