What is the best method for estimating the burden of severe sepsis in the United States?
Author Department
Medicine
Document Type
Article, Peer-reviewed
Publication Date
8-1-2012
Abstract
PURPOSE: The aim of the study was to compare estimates of hospitalizations, outcomes, and costs produced by 2 approaches for defining severe sepsis. METHODS: We used the Nationwide Inpatient Sample to study adults hospitalized in the United States in 2007. We defined severe sepsis using 2 previously published algorithms: (1) the presence of a principal or secondary diagnosis of septicemia combined with organ dysfunction or (2) the presence of a principal or secondary diagnosis of septicemia or another infection (eg, pneumonia) combined with organ dysfunction. For each approach, we calculated the weighted frequency of hospitalizations, population-based mortality rates, and geometric mean costs. RESULTS: A total of 719099 (SD, 16676) hospitalizations had a diagnosis of septicemia and a diagnosis of organ dysfunction. A total of 2.5 million hospitalizations were recorded, with a diagnosis code for either septicemia or infection combined with a diagnosis code for organ dysfunction. Hospitalizations without a diagnosis code for septicemia had lower rates of respiratory failure (35% vs 51%, P < .001) or shock (20% vs 46%, P < .001), lower in-hospital mortality (8% vs 29%, P < .001), and lower mean costs. CONCLUSIONS: An approach that requires a diagnosis code for septicemia and a diagnosis code for organ dysfunction yields estimates of disease burden and outcomes that are more consistent with chart-based studies. Copyright © 2012 Elsevier Inc. All rights reserved.
Publication ISSN
0179-0358
Recommended Citation
Lagu T, Rothberg MB, Shieh MS, Pekow PS, Steingrub JS, Lindenauer PK. What is the best method for estimating the burden of severe sepsis in the United States? J Crit Care 2012 Aug;27(4):414e1-9.
