Outcomes and resource use of sepsis-associated stays by presence on admission, severity, and hospital type

Research output: Contribution to journalArticle

Stephen L. Jones, Carol M. Ashton, Lisa B. Kiehne, Juan C. Nicolas, Alexis L. Rose, Beverly A. Shirkey, Faisal N. Masud, Nelda Wray

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
Volume54
Issue number3
DOIs
StatePublished - 2016

PMID: 26759980

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Outcomes and resource use of sepsis-associated stays by presence on admission, severity, and hospital type. / Jones, Stephen L.; Ashton, Carol M.; Kiehne, Lisa B.; Nicolas, Juan C.; Rose, Alexis L.; Shirkey, Beverly A.; Masud, Faisal N.; Wray, Nelda.

In: Medical care, Vol. 54, No. 3, 2016, p. 303-310.

Research output: Contribution to journalArticle

Harvard

Jones, SL, Ashton, CM, Kiehne, LB, Nicolas, JC, Rose, AL, Shirkey, BA, Masud, FN & Wray, N 2016, 'Outcomes and resource use of sepsis-associated stays by presence on admission, severity, and hospital type' Medical care, vol. 54, no. 3, pp. 303-310. https://doi.org/10.1097/MLR.0000000000000481

APA

Jones, S. L., Ashton, C. M., Kiehne, L. B., Nicolas, J. C., Rose, A. L., Shirkey, B. A., ... Wray, N. (2016). Outcomes and resource use of sepsis-associated stays by presence on admission, severity, and hospital type. Medical care, 54(3), 303-310. https://doi.org/10.1097/MLR.0000000000000481

Vancouver

Jones SL, Ashton CM, Kiehne LB, Nicolas JC, Rose AL, Shirkey BA et al. Outcomes and resource use of sepsis-associated stays by presence on admission, severity, and hospital type. Medical care. 2016;54(3):303-310. https://doi.org/10.1097/MLR.0000000000000481

Author

Jones, Stephen L. ; Ashton, Carol M. ; Kiehne, Lisa B. ; Nicolas, Juan C. ; Rose, Alexis L. ; Shirkey, Beverly A. ; Masud, Faisal N. ; Wray, Nelda. / Outcomes and resource use of sepsis-associated stays by presence on admission, severity, and hospital type. In: Medical care. 2016 ; Vol. 54, No. 3. pp. 303-310.

BibTeX

@article{12904330ac3844e5a944bbb4799f483d,
title = "Outcomes and resource use of sepsis-associated stays by presence on admission, severity, and hospital type",
abstract = "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.",
keywords = "Cms Innovation Awards, Hospital cost, Hospital utilization, Inpatient death rates, Multiple stay rate, Outcomes of care, Sepsis, Septic shock, Severe sepsis",
author = "Jones, {Stephen L.} and Ashton, {Carol M.} and Kiehne, {Lisa B.} and Nicolas, {Juan C.} and Rose, {Alexis L.} and Shirkey, {Beverly A.} and Masud, {Faisal N.} and Nelda Wray",
year = "2016",
doi = "10.1097/MLR.0000000000000481",
language = "English (US)",
volume = "54",
pages = "303--310",
journal = "Medical care",
issn = "0025-7079",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

RIS

TY - JOUR

T1 - Outcomes and resource use of sepsis-associated stays by presence on admission, severity, and hospital type

AU - Jones, Stephen L.

AU - Ashton, Carol M.

AU - Kiehne, Lisa B.

AU - Nicolas, Juan C.

AU - Rose, Alexis L.

AU - Shirkey, Beverly A.

AU - Masud, Faisal N.

AU - Wray, Nelda

PY - 2016

Y1 - 2016

N2 - 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.

AB - 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.

KW - Cms Innovation Awards

KW - Hospital cost

KW - Hospital utilization

KW - Inpatient death rates

KW - Multiple stay rate

KW - Outcomes of care

KW - Sepsis

KW - Septic shock

KW - Severe sepsis

UR - http://www.scopus.com/inward/record.url?scp=84959084860&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84959084860&partnerID=8YFLogxK

U2 - 10.1097/MLR.0000000000000481

DO - 10.1097/MLR.0000000000000481

M3 - Article

VL - 54

SP - 303

EP - 310

JO - Medical care

T2 - Medical care

JF - Medical care

SN - 0025-7079

IS - 3

ER -

ID: 19899008