National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Antibiotics (5)
- Antimicrobial Stewardship (3)
- Children/Adolescents (3)
- Community-Acquired Infections (2)
- Comparative Effectiveness (1)
- Critical Care (2)
- Data (1)
- Diagnostic Safety and Quality (1)
- Elderly (1)
- Electronic Health Records (EHRs) (2)
- Emergency Department (2)
- Evidence-Based Practice (2)
- Guidelines (3)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Cost and Utilization Project (HCUP) (5)
- Health Information Technology (HIT) (3)
- Hospitalization (4)
- Hospitals (8)
- Infectious Diseases (2)
- Inpatient Care (5)
- Intensive Care Unit (ICU) (2)
- Medication (5)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (2)
- Mortality (9)
- Obesity (1)
- Outcomes (2)
- Patient Safety (1)
- Pneumonia (2)
- Policy (1)
- Provider (1)
- Provider: Physician (1)
- Provider Performance (2)
- Quality Improvement (2)
- Quality Indicators (QIs) (1)
- Quality Measures (3)
- Quality of Care (6)
- Racial and Ethnic Minorities (2)
- Risk (3)
- (-) Sepsis (27)
- Stroke (2)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 27 Research Studies DisplayedHsu HE, Abanyie F, Agus MSD
A national approach to pediatric sepsis surveillance.
The authors described the challenges specific to pediatric sepsis surveillance. They then proposed a preliminary pediatric sepsis event surveillance definition and outlined next steps for refining and validating these criteria so that they may be used to estimate the national burden of pediatric sepsis and support site-specific surveillance to complement ongoing initiatives to improve sepsis prevention, recognition, and treatment.
AHRQ-funded; HS023827; HS025008.
Citation: Hsu HE, Abanyie F, Agus MSD .
A national approach to pediatric sepsis surveillance.
Pediatrics 2019 Dec;144(6). doi: 10.1542/peds.2019-1790..
Keywords: Children/Adolescents, Sepsis
Barbash IJ, Kahn JM
Sepsis quality in safety-net hospitals: an analysis of Medicare's SEP-1 performance measure.
Researchers studied the relationship between hospital safety-net status and performance on Medicare's SEP-1 quality measure. Data from 2827 hospitals were analyzed. They found that existing sepsis policies may harm safety-net hospitals and widen health disparities. They suggest that strategies to promote collaboration among hospitals may be an avenue for sepsis performance improvement in these hospitals.
AHRQ-funded; HS025455.
Citation: Barbash IJ, Kahn JM .
Sepsis quality in safety-net hospitals: an analysis of Medicare's SEP-1 performance measure.
J Crit Care 2019 Dec;54:88-93. doi: 10.1016/j.jcrc.2019.08.009.
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Keywords: Sepsis, Quality Measures, Quality of Care, Hospitals, Provider Performance, Quality Improvement
Parrish KL, Wylie KM, Reich PJ
Carriage of the toxic shock syndrome toxin gene by contemporary community-associated Staphylococcus aureus isolates.
J Pediatric Infect Dis Soc 2019 Nov 6;8(5):470-73. doi: 10.1093/jpids/piy098.
In this study, the investigators report the prevalence of the tst-1 gene among 252 methicillin-susceptible Staphylococcus aureus (MSSA) isolates and 458 methicillin-resistant S aureus (MRSA) isolates collected from 531 subjects between 2008 and 2017.
In this study, the investigators report the prevalence of the tst-1 gene among 252 methicillin-susceptible Staphylococcus aureus (MSSA) isolates and 458 methicillin-resistant S aureus (MRSA) isolates collected from 531 subjects between 2008 and 2017.
AHRQ-funded; HS024269.
Citation: Parrish KL, Wylie KM, Reich PJ .
Carriage of the toxic shock syndrome toxin gene by contemporary community-associated Staphylococcus aureus isolates.
Carriage of the toxic shock syndrome toxin gene by contemporary community-associated Staphylococcus aureus isolates.
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Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Infectious Diseases, Community-Acquired Infections, Sepsis, Patient Safety
Law AC, Stevens JP, Walkey AJ
National trends in timing of death among patients with septic shock, 1994-2014.
Investigators sought to assess trends in the timing of mortality among patients with septic shock. Using HCUP data, they found that septic shock 48-hour, 3-14-day, and greater than 14-day mortality declined markedly over two decades; in contrast, patients with acute respiratory failure only experienced marked decreases in greater than 14-day in-hospital mortality rates.
AHRQ-funded; HS024288.
Citation: Law AC, Stevens JP, Walkey AJ .
National trends in timing of death among patients with septic shock, 1994-2014.
Crit Care Med 2019 Nov;47(11):1493-96. doi: 10.1097/ccm.0000000000003956..
Keywords: Healthcare Cost and Utilization Project (HCUP), Sepsis, Mortality, Hospitals
Rhee C, Wang R, Zhang Z
Epidemiology of hospital-onset versus community-onset sepsis in U.S. hospitals and association with mortality: a retrospective analysis using electronic clinical data.
Prior studies have reported that hospital-onset sepsis is associated with higher mortality rates than community-onset sepsis. Most studies, however, have used inconsistent case-finding methods and applied limited risk-adjustment for potential confounders. In this study, the investigators used consistent sepsis criteria and detailed electronic clinical data to elucidate the epidemiology and mortality associated with hospital-onset sepsis.
AHRQ-funded; HS025008.
Citation: Rhee C, Wang R, Zhang Z .
Epidemiology of hospital-onset versus community-onset sepsis in U.S. hospitals and association with mortality: a retrospective analysis using electronic clinical data.
Crit Care Med 2019 Sep;47(9):1169-76. doi: 10.1097/ccm.0000000000003817..
Keywords: Mortality, Sepsis
Goldstein E, Olesen SW, Karaca Z
AHRQ Author: Karaca Z
Levels of outpatient prescribing for four major antibiotic classes and rates of septicemia hospitalization in adults in different US states - a statistical analysis.
The authors related state-specific rates of outpatient prescribing overall for oral fluoroquinolones, penicillins, macrolides, and cephalosporins between 2011 and 2012 to state-specific rates of septicemia hospitalization in several age groups of adults. They found positive associations between the rates of prescribing for penicillins and the rates of hospitalization with septicemia in US adults aged 50-84 years and recommended further studies.
AHRQ-authored.
Citation: Goldstein E, Olesen SW, Karaca Z .
Levels of outpatient prescribing for four major antibiotic classes and rates of septicemia hospitalization in adults in different US states - a statistical analysis.
BMC Public Health 2019 Aug 19;19(1):1138. doi: 10.1186/s12889-019-7431-8..
Keywords: Healthcare Cost and Utilization Project (HCUP), Antibiotics, Antimicrobial Stewardship, Sepsis, Medication, Hospitalization
Anand V, Zhang Z, Kadri SS
Epidemiology of quick sequential organ failure assessment criteria in undifferentiated patients and association with suspected infection and sepsis.
In this study, researchers examined the epidemiology and prognostic value of Quick Sequential Organ Failure Assessment (qSOFA) in undifferentiated patients. They found that only one in three patients who were qSOFA-positive on admission had suspected infection, and one in six had sepsis. They further found that qSOFA had low sensitivity for identifying suspected infection and sepsis, and its prognostic significance was not specific to infection. They recommended a need for more sensitive and specific tools for sepsis screening and risk stratification.
AHRQ-funded; HS025008.
Citation: Anand V, Zhang Z, Kadri SS .
Epidemiology of quick sequential organ failure assessment criteria in undifferentiated patients and association with suspected infection and sepsis.
Chest 2019 Aug;156(2):289-97. doi: 10.1016/j.chest.2019.03.032..
Keywords: Sepsis, Diagnostic Safety and Quality
Barbash IJ, Davis B, Kahn JM
National performance on the Medicare SEP-1 sepsis quality measure.
Researchers characterized national performance on the sepsis measure known as SEP-1. They found that the majority of eligible hospitals reported SEP-1 data, and overall bundle compliance was highly variable. Further, SEP-1 performance was associated with structural hospital characteristics and performance on other measures of hospital quality, providing preliminary support for SEP-1 performance as a marker of timely hospital sepsis care.
AHRQ-funded; HS025455.
Citation: Barbash IJ, Davis B, Kahn JM .
National performance on the Medicare SEP-1 sepsis quality measure.
Crit Care Med 2019 Aug;47(8):1026-32. doi: 10.1097/ccm.0000000000003613..
Keywords: Sepsis, Quality Indicators (QIs), Quality Measures, Quality of Care, Hospitals, Provider Performance
Trent SA, Jarou ZJ, Havranek EP
Variation in emergency department adherence to treatment guidelines for inpatient pneumonia and sepsis: a retrospective cohort study.
Evidence-based clinical practice guidelines (CPGs) for the treatment of pneumonia and sepsis have existed for many years with multiple studies suggesting improved patient outcomes. Despite their importance, little is known about variation in emergency department (ED) adherence to these CPGs. The objectives of this study were to estimate variation in ED adherence across CPGs for pneumonia and sepsis and identify patient, provider, and environmental factors associated with adherence.
AHRQ-funded; HS022400.
Citation: Trent SA, Jarou ZJ, Havranek EP .
Variation in emergency department adherence to treatment guidelines for inpatient pneumonia and sepsis: a retrospective cohort study.
Acad Emerg Med 2019 Aug;26(8):908-20. doi: 10.1111/acem.13639.
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Keywords: Emergency Department, Evidence-Based Practice, Guidelines, Inpatient Care, Pneumonia, Sepsis
Weinberger J, Rhee C, Klompas M
A critical analysis of the literature on time-to-antibiotics in suspected sepsis.
The Surviving Sepsis Campaign recommends immediate antibiotics for all patients with suspected sepsis and septic shock, ideally within 1 hour of recognition. An accurate understanding of the precise relationship between time-to-antibiotics and mortality for patients with possible sepsis is therefore critical. In this study, the investigators elaborate on potential sources of bias and try to distill a better understanding of what the true relationship between time-to-antibiotics and mortality may be for patients with suspected sepsis or septic shock.
AHRQ-funded; HS025008.
Citation: Weinberger J, Rhee C, Klompas M .
A critical analysis of the literature on time-to-antibiotics in suspected sepsis.
J Infect Dis 2020 Jul 21;222(Suppl 2):S110-s18. doi: 10.1093/infdis/jiaa146..
Keywords: Sepsis, Antibiotics, Medication, Antimicrobial Stewardship, Quality Improvement, Quality of Care, Mortality
Kahn JM, Davis BS, Yabes JG
Association between state-mandated protocolized sepsis care and in-hospital mortality among adults with sepsis.
The purpose of this study was to evaluate the association between New York State sepsis regulations and the outcomes of patients hospitalized with sepsis. Results showed that, in New York State, mandated protocolized sepsis care was associated with a greater decrease in sepsis mortality compared with sepsis mortality in control states (Florida, Maryland, Massachusetts, and New Jersey) that did not implement sepsis regulations. The authors add that, because baseline mortality rates differ between New York and the comparison states, it is uncertain whether these findings will be generalizable to other states.
AHRQ-funded; HS025146.
Citation: Kahn JM, Davis BS, Yabes JG .
Association between state-mandated protocolized sepsis care and in-hospital mortality among adults with sepsis.
JAMA 2019 Jul 16;322(3):240-50. doi: 10.1001/jama.2019.9021..
Keywords: Guidelines, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Mortality, Outcomes, Policy, Sepsis
Goldstein E, MacFadden DR, Karaca Z
AHRQ Author: Karaca Z Steiner CA
Antimicrobial resistance prevalence, rates of hospitalization with septicemia and rates of mortality with sepsis in adults in different US states.
Researchers studied the relation between the prevalence of resistance to various antibiotics in different bacteria and rates of sepsis-related outcomes. They found that, among the different combinations of antibiotics/bacteria, prevalence of resistance to fluoroquinolones in E. coli had the strongest association with septicemia hospitalization rates for individuals aged over 50 years, and with sepsis mortality rates for individuals aged 18-84 years. They also found a number of positive correlations between prevalence of resistance for different combinations of antibiotics/bacteria and septicemia hospitalization/sepsis mortality rates in adults.
AHRQ-authored.
Citation: Goldstein E, MacFadden DR, Karaca Z .
Antimicrobial resistance prevalence, rates of hospitalization with septicemia and rates of mortality with sepsis in adults in different US states.
Int J Antimicrob Agents 2019 Jul;54(1):23-34. doi: 10.1016/j.ijantimicag.2019.03.004..
Keywords: Antibiotics, Antimicrobial Stewardship, Healthcare Cost and Utilization Project (HCUP), Hospitals, Hospitalization, Medication, Mortality, Sepsis
Pepper DJ, Sun J, Rhee C
Procalcitonin-guided antibiotic discontinuation and mortality in critically ill adults: a systematic review and meta-analysis.
This study is a systematic review and meta-analysis on survival outcomes of using procalcitonin (PCT)-guided antibiotic discontinuation on critically ill adults. The study quality was assessing with the Cochrane risk of bias tool, and GRADEpro was used to grade evidence. PCT-guided discontinuation was associated with decreased mortality, but there was a high risk of bias in many of the studies reviewed with a low certainty of evidence. The authors suggest properly designed studies with mortality as the primary outcome is needed to further answer this question.
AHRQ-funded; HS025008.
Citation: Pepper DJ, Sun J, Rhee C .
Procalcitonin-guided antibiotic discontinuation and mortality in critically ill adults: a systematic review and meta-analysis.
Chest 2019 Jun;155(6):1109-18. doi: 10.1016/j.chest.2018.12.029..
Keywords: Antibiotics, Critical Care, Evidence-Based Practice, Medication, Mortality, Outcomes, Sepsis
Hartman ME, Saeed MJ, Powell KN
The comparative epidemiology of pediatric severe sepsis.
The purpose of this study was to determine if the coding strategies used to identify severe sepsis in administrative data sets could identify cases with comparable case mix, hospitalization characteristics, and outcomes as a cohort of children diagnosed with severe sepsis. HCUP data was used. Results showed that the ICD-9-CM codes for "severe sepsis" and "septic shock" identify smaller but higher acuity cohorts of patients that more closely resemble the children enrolled in the largest clinical trial of pediatric severe sepsis to date.
AHRQ-funded; HS019455.
Citation: Hartman ME, Saeed MJ, Powell KN .
The comparative epidemiology of pediatric severe sepsis.
J Intensive Care Med 2019 Jun;34(6):472-79. doi: 10.1177/0885066617735783..
Keywords: Children/Adolescents, Healthcare Cost and Utilization Project (HCUP), Sepsis
Kempker JA, Panwar B, Judd SE
Plasma 25-hydroxyvitamin d and the longitudinal risk of sepsis in the REGARDS cohort..
In this paper, researchers studied low baseline plasma 25-hydroxyvitamin D (25(OH)D) and its association with long-term risk of sepsis. Data from the Reasons for Geographic and Racial Differences in Stroke study was used. Findings reveals that, among community-dwelling US adults, low plasma 25(OH)D measured at a time of relative health was independently associated with increased risk of sepsis.
AHRQ-funded; HS025240.
Citation: Kempker JA, Panwar B, Judd SE .
Plasma 25-hydroxyvitamin d and the longitudinal risk of sepsis in the REGARDS cohort..
Clin Infect Dis 2019 May 17;68(11):1926-31. doi: 10.1093/cid/ciy794..
Keywords: Community-Acquired Infections, Racial and Ethnic Minorities, Risk, Sepsis, Stroke
Pepper DJ, Demirkale CY, Sun J
Does obesity protect against death in sepsis? A retrospective cohort study of 55,038 adult patients.
The purpose of this study was to estimate the relationship between body mass index and sepsis mortality using detailed clinical data for case detection and risk adjustment. In adults with clinically-defined sepsis, results demonstrated lower short-term mortality in patients with higher body mass indices compared with those with normal body mass indices and higher short-term mortality in those with low body mass indices. Understanding how obesity improves survival in sepsis would inform prognostic and therapeutic strategies.
AHRQ-funded; HS025008.
Citation: Pepper DJ, Demirkale CY, Sun J .
Does obesity protect against death in sepsis? A retrospective cohort study of 55,038 adult patients.
Crit Care Med 2019 May;47(5):643-50. doi: 10.1097/ccm.0000000000003692..
Keywords: Sepsis, Obesity, Mortality
Trent SA, Havranek EP, Ginde AA
Effect of audit and feedback on physician adherence to clinical practice guidelines for pneumonia and sepsis.
This study examined the effect of feedback with blinded peer comparison on emergency physician adherence to guidelines for appropriate antibiotic administration for inpatient pneumonia and completion of the 3-hour Surviving Sepsis Bundle for patients with severe sepsis. A quasi-experiment was conducted with attending physicians randomized into 6 clusters at a single urban safety net hospital. Feedback with blinded peer comparison significantly improved guideline adherence from 52% to 65% with feedback.
AHRQ-funded; HS022400.
Citation: Trent SA, Havranek EP, Ginde AA .
Effect of audit and feedback on physician adherence to clinical practice guidelines for pneumonia and sepsis.
Am J Med Qual 2019 May/Jun;34(3):217-25. doi: 10.1177/1062860618796947..
Keywords: Antibiotics, Emergency Department, Guidelines, Infectious Diseases, Inpatient Care, Medication, Pneumonia, Provider, Provider: Physician, Sepsis
Darby JL, Davis BS, Barbash IJ
An administrative model for benchmarking hospitals on their 30-day sepsis mortality.
The goal of this study was to develop an administrative risk-adjustment model suitable for profiling hospitals on their 30-day mortality rates for patients with sepsis. The investigators concluded that a novel claims-based risk-adjustment model demonstrated wide variation in risk-standardized 30-day sepsis mortality rates across hospitals. Individual hospitals' performance rankings were stable across years and after the addition of laboratory data. They assert that this model provides a robust way to rank hospitals on sepsis mortality while adjusting for patient risk.
AHRQ-funded; HS025455.
Citation: Darby JL, Davis BS, Barbash IJ .
An administrative model for benchmarking hospitals on their 30-day sepsis mortality.
BMC Health Serv Res 2019 Apr 11;19(1):221. doi: 10.1186/s12913-019-4037-x..
Keywords: Hospitals, Mortality, Quality of Care, Sepsis
Rhee C, Jentzsch MS, Kadri SS
Variation in identifying sepsis and organ dysfunction using administrative versus electronic clinical data and impact on hospital outcome comparisons.
Administrative claims data are commonly used for sepsis surveillance, research, and quality improvement. However, variations in diagnosis, documentation, and coding practices for sepsis and organ dysfunction may confound efforts to estimate sepsis rates, compare outcomes, and perform risk adjustment. In this study, the investigators evaluated hospital variation in the sensitivity of claims data relative to clinical data from electronic health records and its impact on outcome comparisons.
AHRQ-funded; HS025008.
Citation: Rhee C, Jentzsch MS, Kadri SS .
Variation in identifying sepsis and organ dysfunction using administrative versus electronic clinical data and impact on hospital outcome comparisons.
Crit Care Med 2019 Apr;47(4):493-500. doi: 10.1097/ccm.0000000000003554..
Keywords: Sepsis, Electronic Health Records (EHRs), Health Information Technology (HIT)
Delahanty RJ, Alvarez J, Flynn LM
Development and evaluation of a machine learning model for the early identification of patients at risk for sepsis.
In this study, the investigators aimed to use machine learning to develop a new sepsis screening tool, the Risk of Sepsis (RoS) score, and compare it with a slate of benchmark sepsis-screening tools, including the Systemic Inflammatory Response Syndrome, Sequential Organ Failure Assessment (SOFA), qSOFA, Modified Early Warning Score, and National Early Warning Score. The investigators concluded that in this retrospective study, RoS was more timely and discriminant than benchmark screening tools, including those recommend by the Sepsis-3 Task Force.
AHRQ-funded; HS024750.
Citation: Delahanty RJ, Alvarez J, Flynn LM .
Development and evaluation of a machine learning model for the early identification of patients at risk for sepsis.
Ann Emerg Med 2019 Apr;73(4):334-44. doi: 10.1016/j.annemergmed.2018.11.036..
Keywords: Health Information Technology (HIT), Hospitals, Risk, Sepsis
Mahalingam M, Moore Jx, Donnelly JP
Frailty syndrome and risk of sepsis in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort.
This study examined the association between frailty (weakness, exhaustion, and low physical activity) and the risk of sepsis in stroke patients. Data from the cohort study Reasons for Geographic and Racial Differences in Stroke (REGARDS) was used. There was an associated increase in sepsis hospitalizations and 30-day case fatalities from sepsis in stroke patients with more frailty indicators.
AHRQ-funded; HS013852.
Citation: Mahalingam M, Moore Jx, Donnelly JP .
Frailty syndrome and risk of sepsis in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort.
J Intensive Care Med 2019 Apr;34(4):292-300. doi: 10.1177/0885066617715251..
Keywords: Elderly, Racial and Ethnic Minorities, Risk, Sepsis, Stroke
Kempker JA, Kramer MR, Waller LA
State-level hospital compliance with and performance in the Centers for Medicaid & Medicare Services' Early Management Severe Sepsis and Septic Shock Bundle.
This research letter discusses a study that measured state-level hospital compliance and performance in the Centers for Medicaid & Medicare Services’(CMS) Early Management Severe Sepsis and Septic Shock Bundle (SEP-1) inpatient quality measure. There was a wide range of compliance from 97% (New Jersey) to North Dakota (15.9%). There was a state average of 48%.
AHRQ-funded; HS025240.
Citation: Kempker JA, Kramer MR, Waller LA .
State-level hospital compliance with and performance in the Centers for Medicaid & Medicare Services' Early Management Severe Sepsis and Septic Shock Bundle.
Crit Care 2019 Mar 18;23(1):92. doi: 10.1186/s13054-019-2382-0..
Keywords: Hospitals, Inpatient Care, Quality of Care, Quality Measures, Sepsis
Rhee C, Zhang Z, Kadri SS
Sepsis surveillance using adult sepsis events simplified eSOFA criteria versus sepsis-3 sequential organ failure assessment criteria.
This retrospective cohort study compared simplified organ dysfunction criteria optimized for electronic health records (eSOFA) with Sequential Organ Failure Assessment with regard to sepsis prevalence, overlap, and outcomes using 111 U.S. hospitals in the Cerner HealthFacts dataset. Clinical indicators of presumed infection, such as blood cultures and antibiotics, were identified concurrent with either: an increase in Sequential Organ Failure Assessment score by 2 or more points (Sepsis-3) or one or more eSOFA criteria. The authors conclude that the Adult Sepsis Event's eSOFA organ dysfunction criteria identify a smaller, more severely ill sepsis cohort when compared with the Sequential Organ Failure Assessment score, although there is overlap between the two and both show similar clinical characteristics.
AHRQ-funded; HS025008.
Citation: Rhee C, Zhang Z, Kadri SS .
Sepsis surveillance using adult sepsis events simplified eSOFA criteria versus sepsis-3 sequential organ failure assessment criteria.
Crit Care Med 2019 Mar;47(3):307-14. doi: 10.1097/ccm.0000000000003521..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Sepsis
Lindell RB, Nishisaki A, Weiss SL
Comparison of methods for identification of pediatric severe sepsis and septic shock in the Virtual Pediatric Systems Database.
This study compared the use of Virtual Pediatric Systems with traditional use of International Classification of Diseases, 9th edition (ICD) to identify children with severe sepsis or septic shock in PICU settings. Two different systems were compared “Martin” and “Angus”. Both showed good agreement, but ICD9 identified a smaller more accurate cohort of children. Additional analysis of discrepancies between the reference standard the two virtual systems showed that prospective screening missed 66 patients who were diagnosed with severe sepsis or severe shock. Once they were included in the standard cohort, agreement improved with a positive predictive value of 70%.
AHRQ-funded; HS024511; HS022464.
Citation: Lindell RB, Nishisaki A, Weiss SL .
Comparison of methods for identification of pediatric severe sepsis and septic shock in the Virtual Pediatric Systems Database.
Crit Care Med 2019 Feb;47(2):e129-e35. doi: 10.1097/ccm.0000000000003541..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Data, Sepsis
Rhee C, Jones TM, Hamad Y
Prevalence, underlying causes, and preventability of sepsis-associated mortality in US acute care hospitals.
The purpose of this study was to estimate the prevalence, underlying causes, and preventability of sepsis-associated mortality in acute care hospitals. A retrospective medical record review was conducted of 568 randomly selected adults admitted to six US academic and community hospitals who died in the hospital or were discharged to hospice and not readmitted. Medical records were reviewed. Sepsis was found to be the most common immediate cause of death; however, most underlying causes were related to severe chronic comorbidities. Most sepsis-associated deaths were unlikely to be preventable through better hospital-based care. The authors conclude that further innovations in the prevention and care of underlying conditions may be necessary before a significant reduction in sepsis-associated deaths can be achieved.
AHRQ-funded; HS025008.
Citation: Rhee C, Jones TM, Hamad Y .
Prevalence, underlying causes, and preventability of sepsis-associated mortality in US acute care hospitals.
JAMA Netw Open 2019 Feb;2(2):e187571. doi: 10.1001/jamanetworkopen.2018.7571..
Keywords: Mortality, Sepsis, Hospitals, Inpatient Care