Objective: To establish a baseline for the incidence of sepsis by severity and presence on admission in acute care hospital settings before implementation of a broad sepsis screening and response initiative. Methods: A retrospective cohort study using hospital discharge abstracts of 5672 patients, aged 18 years and above, with sepsisassociated stays between February 2012 and January 2013 at an academic medical center and 5 community hospitals in Texas. Results: Sepsis was present on admission in almost 85% of cases and acquired in-hospital in the remainder. The overall inpatient death rate was 17.2%, but was higher in hospital-acquired sepsis (38.6%, medical; 29.2%, surgical) and Stages 2 (17.6%) and 3 (36.4%) compared with Stage 1 (5.9%). Patients treated at the academic medical center had a higher death rate (22.5% vs. 15.1%, P < 0.001) and were more costly ($68,050 ± 184,541 vs. $19,498 ± 31,506, P < 0.001) versus community hospitals. Conclusions: Greater emphasis is needed on public awareness of sepsis and the detection of sepsis in the prehospitalization and early hospitalization period. Hospital characteristics and case mix should be accounted for in cross-hospital comparisons of sepsis outcomes and costs.

Original languageEnglish (US)
Pages (from-to)303-310
Number of pages8
JournalMedical Care
Issue number3
StatePublished - 2016


  • Cms Innovation Awards
  • Hospital cost
  • Hospital utilization
  • Inpatient death rates
  • Multiple stay rate
  • Outcomes of care
  • Sepsis
  • Septic shock
  • Severe sepsis

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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