Sepsis Contributes to Half of All Hospital Deaths

Sepsis, an inflammatory response to infection, appears to be a contributor to or major cause of as many as half of in-hospital deaths, according to a new study.

Researchers at Kaiser Permanente Santa Clara Medical Center (CA, USA) accessed the US Nationwide Inpatient Sample (NIS) database, which included 6,555,621 patients from 1,051 hospitals during 2010 who were hospitalized for any reason (representing 20% of the national subsample). The study also included 483,828 patients who stayed overnight at the Kaiser Permanente Northern California system from 2010 to 2012. The researchers included information on sepsis diagnosis on admission, and also scoured admission records for hospital codes signifying a sepsis diagnosis.

The results showed that depending on the definition of sepsis, 34.7%–52% of deaths in the NIS were due, in part, to a sepsis diagnosis, and in the Kaiser Permanente cohort, sepsis was a contributor to 44.2%–55.9% of the deaths. Combined analysis listed sepsis as an explicit cause of death in 36.7% of cases, and 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%, and the implicit percentage rose to 66.6%. The study was presented at the American Thoracic Society (ATS) annual meeting, held during May 2014 in San Diego (CA, USA).

“Most of these patients had sepsis at admission,” said study author and presenter Vincent Liu, MD. “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.”

Sepsis is a whole-body inflammatory state caused by the immune system's response to a serious infection, most commonly bacteria, but also fungi, viruses, and parasites in the blood, urinary tract, lungs, skin, or other tissues. Sepsis symptoms include those related to a specific infection, but are usually accompanied by high fevers, hot, flushed skin, elevated heart rate, hyperventilation, altered mental status, swelling, and low blood pressure. Sepsis causes millions of deaths globally each year.

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Kaiser Permanente Santa Clara Medical Center