A multi-institution analysis of the records of two large cohorts has concluded sepsis may contribute to half of all hospital deaths, according to a study presented at the annual conference of the American Thoracic Society.

The researchers quantified the contribution of sepsis to mortality in two complementary inpatient cohorts from Kaiser Permanente Northern California (KPNC) and the Healthcare Cost and Utilization Project Nationwide Inpatient Sample. The KPNC cohort included 482 828 adults with overnight, nonobstetrical hospitalizations at 21 KPNC hospitals between 2010 and 2012, and the NIS, a nationally representative sample of 1051 hospitals, included 6.5 million unweighted adult hospitalizations in 2010.

"In two complementary hospital cohorts, we found that sepsis contributed to one in every two to three deaths, and most of these patients had sepsis at admission," the authors wrote. "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."

They also found patients with initially less severe sepsis made up the majority of sepsis deaths.

"Performance improvement efforts in the treatment of sepsis have primarily focused on standardizing care for the most severely ill patients, whereas interventions for treating other patients with sepsis are less well defined," they wrote. "Given their prevalence, improving standardized care for patients with less severe sepsis could drive future reductions in hospital mortality."

The data were also published as a research letter in JAMA. In related news, researchers from the University of California at Davis have shown that electronic health records can be used effectively to predict the onset of sepsis, a leading cause of death and hospitalization in the United States. 

In a recent study using routine information of hospitalized patients--such as blood pressure, respiratory rate, temperature and white blood cell count--researchers analyzed data from the EHRs of 741 patients with sepsis and found that vital signs combined with serum white blood cell count can accurately predict sepsis, which is associated with increased blood levels of lactate. In addition, they found that lactate level, blood pressure and respiratory rate could determine a patient’s risk of death from sepsis.

 

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