Journal article
Clinical and epidemiological variability in severe sepsis: an ecological study
Journal of epidemiology and community health (1979), Vol.72(8), pp.741-745
08/2018
DOI: 10.1136/jech-2018-210501
PMCID: PMC7027349
PMID: 29636401
Abstract
BackgroundTo assess clinical and epidemiological trends of severe sepsis.MethodsEcological study of patients presenting to the emergency department with severe sepsis or septic shock between 2005 and 2013. Patients were identified using the state-wide hospital administrative database. Key outcomes included incidence rates (IRs) and mortality rates (per 1000 population) by age and medically underserved areas (MUAs), sepsis case fatality rate (deaths per 100 sepsis cases), and proportions of transfer and comorbidities.ResultsThere were 154 019 sepsis cases identified. In 2005, 85+ yo in non-MUAs had a 44% increase in IR compared with those in MUAs, and this difference rose to 74% by 2013. Mortality rates were 1.6 (95% CI 1.3 to 1.8) times greater among 85+ yo in non-MUAs. Mortality rates increased by 1.8% annually, while the sepsis case fatality rate decreased by 7.7%. The proportion of transfer among sepsis cases decreased by 2.1% per year (3.8% in non-MUAs, 0.7% in MUAs).ConclusionsSepsis incidence varies geographically, and access to healthcare is one proposed mechanism that may explain heterogeneity. Over time, we may be capturing higher acuity sepsis cases with better recognition and management, as well as observing differential diagnostic coding documentation by location.
Details
- Title: Subtitle
- Clinical and epidemiological variability in severe sepsis: an ecological study
- Creators
- J Priyanka Vakkalanka - Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USAKarisa K Harland - Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USAMorgan B Swanson - Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USANicholas M Mohr - Department of Anaesthesia, Division of Critical Care, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
- Resource Type
- Journal article
- Publication Details
- Journal of epidemiology and community health (1979), Vol.72(8), pp.741-745
- DOI
- 10.1136/jech-2018-210501
- PMID
- 29636401
- PMCID
- PMC7027349
- NLM abbreviation
- J Epidemiol Community Health
- ISSN
- 0143-005X
- eISSN
- 1470-2738
- Grant note
- DOI: 10.13039/100002076, name: Emergency Medicine Foundation; name: University of Iowa Department of Emergency Medicine; name: University of Iowa Institute for Clinical and Translational Science
- Language
- English
- Date published
- 08/2018
- Academic Unit
- Epidemiology; Emergency Medicine; Anesthesia; Injury Prevention Research Center; Public Policy Center (Archive); Law Faculty
- Record Identifier
- 9984024540202771
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