Sepsis is a condition with significant morbidity, mortality and cost. However, there is limited epidemiological information about the outcomes of patients with sepsis managed in non-ICU services. Our aim was to characterize the population of elderly septic patients managed in non-ICU services and important clinical outcomes in a United States Department of Veterans Affairs (VA).
We conducted a retrospective national cohort study using VA administrative data including subjects >65 years hospitalized with a discharge diagnosis of sepsis in fiscal years 2002–2007, receiving antibiotics within 48 hours of admission and having at least one year of Veterans Affairs outpatient care prior to index admission. We defined sepsis using previously validated lCD-9 codes. We evaluated the following clinical outcomes: 30- and 90-day mortality and length of hospital stay (LOS).
We identified 5,678 elderly patients who were hospitalized in non-ICU services with sepsis during the study period. Of these, most were men (99%) and non-Hispanic whites (63%). The most frequent causes of sepsis were genitourinary (34%), respiratory (23%), and other (35%). The most frequent comorbid conditions were: diabetes (38%), COPD (32%), heart failure (25%), and cerebrovascular disease (21%). Mortality at 30- and 90-days was 39% and 49%, respectively. The mean (Standard Deviation) LOS was 11.5 (18) days.
The population of elderly patients with sepsis managed in non-ICU services is large, with an unexpectedly high 30- and 90-day mortality and LOS. Therefore, a better understanding of the non-ICU septic patients is warranted in order to design strategies to improve patient outcomes.
A large percentage of elderly patients who meet sepsis criteria are being treated in non-ICU settings with an unexpectedly high mortality. Whenever possible; patients who meet criteria for sepsis should be cared for in ICU level settings.
Maria Velez, No Financial Disclosure Information; No Product/Research Disclosure Information