TY - JOUR
T1 - Increasing Sepsis Rates in the United States
T2 - Results From National Inpatient Sample, 2005 to 2014
AU - Rubens, Muni
AU - Saxena, Anshul
AU - Ramamoorthy, Venkataraghavan
AU - Das, Sankalp
AU - Khera, Rohan
AU - Hong, Jonathan
AU - Armaignac, Donna
AU - Veledar, Emir
AU - Nasir, Khurram
AU - Gidel, Louis
N1 - Funding Information:
The authors thank the millions of patients who contributed to the NIS database and the numerous professionals who created the database. The author(s) received no financial support for the research, authorship, and/or publication of this article.
Publisher Copyright:
© The Author(s) 2018.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Objectives: To examine the trends in hospitalization rates, mortality, and costs for sepsis during the years 2005 to 2014. Methods: This was a retrospective serial cross-sectional analysis of patients ≥18 years admitted for sepsis in National Inpatient Sample. Trends in sepsis hospitalizations were estimated, and age- and sex-adjusted rates were calculated for the years 2005 to 2014. Results: There were 541 694 sepsis admissions in 2005 and increased to 1 338 905 in 2014. Sepsis rates increased significantly from 1.2% to 2.7% during the years 2005 to 2014 (relative increase: 123.8%; Ptrend <.001). However, the relative increase changed by 105.8% (Ptrend <.001) after adjusting for age and sex and maintained significance. Although total cost of hospitalization due to sepsis increased significantly from US$22.2 to US$38.1 billion (Ptrend <.001), the mean hospitalization cost decreased significantly from US$46,470 to US$29,290 (Ptrend <.001). Conclusions: Hospitalizations for sepsis increased during the years 2005 to 2014. Our study paradoxically found declining rates of in-hospital mortality, length of stay, and mean hospitalization cost for sepsis. These findings could be due to biases introduced by International Classification of Diseases, Ninth Revision, Clinical Modification coding rules and increased readmission rates or alternatively due to increased awareness and surveillance and changing disposition status. Standardized epidemiologic registries should be developed to overcome these biases.
AB - Objectives: To examine the trends in hospitalization rates, mortality, and costs for sepsis during the years 2005 to 2014. Methods: This was a retrospective serial cross-sectional analysis of patients ≥18 years admitted for sepsis in National Inpatient Sample. Trends in sepsis hospitalizations were estimated, and age- and sex-adjusted rates were calculated for the years 2005 to 2014. Results: There were 541 694 sepsis admissions in 2005 and increased to 1 338 905 in 2014. Sepsis rates increased significantly from 1.2% to 2.7% during the years 2005 to 2014 (relative increase: 123.8%; Ptrend <.001). However, the relative increase changed by 105.8% (Ptrend <.001) after adjusting for age and sex and maintained significance. Although total cost of hospitalization due to sepsis increased significantly from US$22.2 to US$38.1 billion (Ptrend <.001), the mean hospitalization cost decreased significantly from US$46,470 to US$29,290 (Ptrend <.001). Conclusions: Hospitalizations for sepsis increased during the years 2005 to 2014. Our study paradoxically found declining rates of in-hospital mortality, length of stay, and mean hospitalization cost for sepsis. These findings could be due to biases introduced by International Classification of Diseases, Ninth Revision, Clinical Modification coding rules and increased readmission rates or alternatively due to increased awareness and surveillance and changing disposition status. Standardized epidemiologic registries should be developed to overcome these biases.
KW - ICD-9-CM code
KW - cost
KW - hospitalization
KW - length of stay
KW - mortality
KW - sepsis
KW - trend
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U2 - 10.1177/0885066618794136
DO - 10.1177/0885066618794136
M3 - Article
C2 - 30175649
AN - SCOPUS:85088880538
VL - 35
SP - 858
EP - 868
JO - Journal of Intensive Care Medicine
JF - Journal of Intensive Care Medicine
SN - 0885-0666
IS - 9
ER -