Link to the University of Pittsburgh Homepage
Link to the University Library System Homepage Link to the Contact Us Form

Epidemiology of severe sepsis in the United States: Analysis of incidence, outcome, and associated costs of care

Angus, DC and Linde-Zwirble, WT and Lidicker, J and Clermont, G and Carcillo, J and Pinsky, MR (2001) Epidemiology of severe sepsis in the United States: Analysis of incidence, outcome, and associated costs of care. Critical Care Medicine, 29 (7). 1303 - 1310. ISSN 0090-3493

[img] Plain Text (licence)
Available under License : See the attached license file.

Download (1kB)

Abstract

Objective: To determine the incidence, cost, and outcome of severe sepsis in the United States. Design: Observational cohort study. Setting: All nonfederal hospitals (n = 847) in seven U.S. states. Patients: All patients (n = 192,980) meeting criteria for severe sepsis based on the International Classification of Diseases, Ninth Revision, Clinical Modification. Interventions: None. Measurements and Main Results: We linked all 1995 state hospital discharge records (n = 6,621,559) from seven large states with population and hospital data from the U.S. Census, the Centers for Disease Control, the Health Care Financing Administration, and the American Hospital Association. We defined severe sepsis as documented infection and acute organ dysfunction using criteria based on the International Classification of Diseases, Ninth Revision, Clinical Modification. We validated these criteria against prospective clinical and physiologic criteria in a subset of five hospitals. We generated national age- and gender-adjusted estimates of incidence, cost, and outcome. We identified 192,980 cases, yielding national estimates of 751,000 cases (3.0 cases per 1,000 population and 2.26 cases per 100 hospital discharges), of whom 383,000 (51.1%) received intensive care and an additional 130,000 (17.3%) were ventilated in an intermediate care unit or cared for in a coronary care unit. Incidence increased > 100-fold with age (0.2/1,000 in children to 26.2/1,000 in those >85 yrs old). Mortality was 28.6%, or 215,000 deaths nationally, and also increased with age, from 10% in children to 38.4% in those >85 yrs old. Women had lower age-specific incidence and mortality, but the difference in mortality was explained by differences in underlying disease and the site of infection. The average costs per case were $22,100, with annual total costs of $16.7 billion nationally. Costs were higher in infants, nonsurvivors, intensive care unit patients, surgical patients, and patients with more organ failure. The incidence was projected to increase by 1.5% per annum. Conclusions: Severe sepsis is a common, expensive, and frequently fatal condition, with as many deaths annually as those from acute myocardial infarction. It is especially common in the elderly and is likely to increase substantially as the U.S. population ages.


Share

Citation/Export:
Social Networking:
Share |

Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Angus, DCangusdc@pitt.eduANGUSDC
Linde-Zwirble, WT
Lidicker, J
Clermont, Gcler@pitt.eduCLER
Carcillo, J
Pinsky, MRpinsky@pitt.eduPINSKY
Date: 1 January 2001
Date Type: Publication
Journal or Publication Title: Critical Care Medicine
Volume: 29
Number: 7
Page Range: 1303 - 1310
DOI or Unique Handle: 10.1097/00003246-200107000-00002
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
ISSN: 0090-3493
PubMed ID: 11445675
Date Deposited: 20 Mar 2012 16:10
Last Modified: 02 Feb 2019 16:58
URI: http://d-scholarship.pitt.edu/id/eprint/11462

Metrics

Monthly Views for the past 3 years

Plum Analytics

Altmetric.com


Actions (login required)

View Item View Item