Muni Rubens1, Anshul Saxena2, Venkataraghavan Ramamoorthy3, Sankalp Das4, Rohan Khera5, Jonathan Hong6, Donna Armaignac7, Emir Veledar2, Khurram Nasir2,8,9,10,11,12, Louis Gidel7. 1. Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA. 2. Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL, USA. 3. Department of Nutrition and Kinesiology, University of Central Missouri, Warrensburg, MI, USA. 4. Employee Health and Wellness Advantage, Baptist Health South Florida, Miami, FL, USA. 5. Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, USA. 6. Division of Cardiovascular Surgery, Vancouver General Hospital, Vancouver, British Columbia, Canada. 7. Teleheath Center of Excellence, Baptist Health South Florida, Miami, FL, USA. 8. Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA. 9. Miami Cardiac and Vascular Institute, Baptist Health South Florida, Miami, FL, USA. 10. Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA. 11. Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, MD, USA. 12. Center for Outcomes Research & Evaluation (CORE), Yale School of Medicine, New Haven, CT, USA.
Abstract
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%; P trend < .001). However, the relative increase changed by 105.8% (P trend < .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 (P trend < .001), the mean hospitalization cost decreased significantly from US$46,470 to US$29,290 (P trend < .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.
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%; P trend < .001). However, the relative increase changed by 105.8% (P trend < .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 (P trend < .001), the mean hospitalization cost decreased significantly from US$46,470 to US$29,290 (P trend < .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.
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