PURPOSE: Growth in the incidence of severe sepsis (SS) cases was predicted to increase by 1.5% per year due to increasing age of the US population alone. SS with associated multi-system organ dysfunction (MOD) is the leading cause of death in intensive care units. The purpose of this study was to examine the incidence of SS in relation to age and patients’ mix of ICD-9 coded organ dysfunctions.
METHODS: A retrospective database analysis of hospitalized patients in the US with SS from fiscal year (FY) 2002–2006. Data were drawn from the Premier Perspective™ comparative database of clinical and economic information. SS cases were those identified via ICD-9 coding as having diagnosed infection in addition to diagnosed organ dysfunction. MOD was defined as ≥2 ODs. We compared discharge quantities and OD characteristics across 5 years.
RESULTS: While total discharges from 564 hospitals increased 9.8% (30.7 million to 33.7 million) from 2002–2006, SS cases from those hospitals increased more: 55.0% (179,742 to 278,624). The incidence of SS cases among all hospital discharges rose at a mean annual rate of 11.6% (range 6.3–15.1%). The proportion of SS cases ≥65 years old increased by 12.1% on average per year, while the proportion of SS cases having MOD rose less than 1% annually (from 26.4% to 28.7%). The proportion of SS patients with cardiac and renal OD increased by 3.9% and 9.0% on average per year (32.5%–37.9% and 33.3%–47.0% of cases, respectively), while respiratory and neurologic OD decreased by 6.3% and 13.5% on average per year (38.1%–29.4% and 11.7–5.9%, respectively) and hematologic and hepatic OD were consistent (range 19.2%–20.7 and 1.5%–1.8%, respectively).
CONCLUSION: Increases in the proportion of cases age ≥65 or with MOD do not account for the increase in SS cases since 2002. Changes in the mix of diagnosed organ dysfunctions may be associated with increasing SS incidence, however.
CLINICAL IMPLICATIONS: Increasing identification of the risk for SS may reflect changes in the mix of ODs more than certain other factors like advanced age.
DISCLOSURE: Frank Ernst, No Financial Disclosure Information; No Product/Research Disclosure Information