Tuesday, May 20, 2014

Sepsis Contributes to Half of all Northern California Kaiser Hospital Deaths

Medpage Today:
... In reviewing two major databases, research scientist Vincent Liu, MD, an intensivist at Kaiser Permanente in Santa Clara, Calif., said that depending on the definition of sepsis, 34.7% to 52% of deaths in the Healthcare Cost and Utilization Project Nationwide Inpatient Sample were due, in part, to a sepsis diagnosis, and in the Kaiser Permanente Northern California cohort, sepsis was a contributor to 44.2% to 55.9% of the deaths occurring in those hospitals. 
"Most of these patients had sepsis at admission," Liu said in his oral presentation at the American Thoracic Society meeting here. "Given the prominent role it plays in hospital mortality, improved treatment of sepsis -- potentially a final hospital pathway for multiple other underlying conditions -- could offer meaningful improvements in population mortality." 
In performing his study, Liu accessed the Nationwide Inpatient Sample that included 6,555,621 patients who were hospitalized for any reason -- a number than represents 20% of the national subsample. The cohort involved patients from 1,051 hospitals and covered the calendar year 2010. 
The Kaiser Permanente sample included 483,828 patients who stayed overnight at the hospital -- excluding obstetrical cases -- from 2010 to 2012. 
The Kaiser data included information on whether the patient was diagnosed with sepsis on admission. The national sample did not provide that information, Liu said. The research team scoured admission records for hospital codes signifying a sepsis diagnosis. 
In the Kaiser Permanente data, sepsis was listed as an explicit cause of death in 36.7% of cases and was listed as a cause of death in 40.8% of implicit cases. When sepsis or infection was listed as a cause of death in the hospital codes, the explicit percentage was 71.7%; the implicit percentage rose to 66.6%. ...