A study presented at the American Thoracic Society International Conference in San Diego reports that sepsis contributes to death in one out of every two or three hospital fatalities. A majority of the patients who died were admitted with the inflammatory infection response which can cause organ failure, according to the study which is being released early online by JAMA to coincide with the conference.
A Need for Meaningful Improvement
“Given the prominent role it plays in hospital mortality, improved treatment of sepsis could offer meaningful improvements in population mortality”, advised Vincent Liu, MD, MS, who conducted the study together with his colleagues at Kaiser Permanente’s Division of Research in Oakland.
The authors examined the frequency of sepsis in approximately seven million inpatient hospitalisations at Kaiser Permanente Northern California (KPNC) and the Healthcare Cost and Utilisation Project Nationwide Inpatient Sample (NIS). The KPNC subset included 428,828 patients admitted to one of 21 KPNC hospitals for overnight, nonobstetric visits between 2010 and 2012. The NIS cohort comprised the majority of the sample: 6.5 million adults in a representative group of Americans hospitalised in 2010 at one of 1,051 participating facilities.
Sepsis and Mortality Rates
Two groups of inpatients, one from each hospital system, were identified with sepsis, which was characterised as either explicit or implicit. Explicit sepsis cases referred to those with sepsis-related codes; implicit sepsis cases presented evidence of acute organ failure together with infection.
Inpatient deaths in the KPNC group totaled 14,206, almost all had sepsis at the time of hospital admission. 36.9 percent of the patients were identified as having explicit sepsis, while 55.9 percent were cases of implicit sepsis. At NIS locations, 143,312 deaths occurred, 34.7 percent of which were explicit compared to 52 percent of implicit sepsis cases.
More Deaths From Less Severe Cases
The majority of deaths attributed to sepsis involved patients whose sepsis severity was initially low. The researchers attribute this finding to the fact that efforts to improve sepsis treatment have focused on the most seriously ill patients.
“Given their prevalence, improving standardised care for patients with less severe sepsis could drive future reductions in hospital mortality”, the authors write.
According to the article, the effect of sepsis on hospital mortality rates had yet to be fully quantified prior to their study. The often-fatal condition affects millions of people around the globe.Source: JAMA