Updated estimates of sepsis hospitalizations at United States academic medical centers

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...

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Main Authors: Hei Kit Chan, Swapnil Khose, Summer Chavez, Bela Patel, Henry E. Wang
Format: Article
Language:English
Published: Elsevier 2022-08-01
Series:Journal of the American College of Emergency Physicians Open
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Online Access:https://doi.org/10.1002/emp2.12782
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author Hei Kit Chan
Swapnil Khose
Summer Chavez
Bela Patel
Henry E. Wang
author_facet Hei Kit Chan
Swapnil Khose
Summer Chavez
Bela Patel
Henry E. Wang
author_sort Hei Kit Chan
collection DOAJ
description 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.
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spelling doaj-art-6b04931fbbc64af5982829cea1b881be2025-08-20T03:18:16ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522022-08-0134n/an/a10.1002/emp2.12782Updated estimates of sepsis hospitalizations at United States academic medical centersHei Kit Chan0Swapnil Khose1Summer Chavez2Bela Patel3Henry E. Wang4Department of Emergency Medicine, Department of Biostatistics The University of Texas Health Science Center at Houston Houston Texas USADepartment of Epidemiology, Human Genetics & Environmental Sciences, School of Public Health The University of Texas Health Science Center at Houston Houston Texas USADepartment of Emergency Medicine, Department of Biostatistics The University of Texas Health Science Center at Houston Houston Texas USADepartment of Medicine, Division of Critical Care Medicine The University of Texas Health Science Center at Houston Houston Texas USADepartment of Emergency Medicine The Ohio State University Columbus Ohio USAAbstract 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.https://doi.org/10.1002/emp2.12782administrative datadischarge diagnosesepidemiologysepsis
spellingShingle Hei Kit Chan
Swapnil Khose
Summer Chavez
Bela Patel
Henry E. Wang
Updated estimates of sepsis hospitalizations at United States academic medical centers
Journal of the American College of Emergency Physicians Open
administrative data
discharge diagnoses
epidemiology
sepsis
title Updated estimates of sepsis hospitalizations at United States academic medical centers
title_full Updated estimates of sepsis hospitalizations at United States academic medical centers
title_fullStr Updated estimates of sepsis hospitalizations at United States academic medical centers
title_full_unstemmed Updated estimates of sepsis hospitalizations at United States academic medical centers
title_short Updated estimates of sepsis hospitalizations at United States academic medical centers
title_sort updated estimates of sepsis hospitalizations at united states academic medical centers
topic administrative data
discharge diagnoses
epidemiology
sepsis
url https://doi.org/10.1002/emp2.12782
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