Hospitals with a high volume of sepsis admissions have lowest mortality rates
Research Activities, March 2011, No. 367
In patients with sepsis, their bloodstream is completely overwhelmed by bacteria from another infection in their body. Sepsis is a potentially life-threatening condition, which requires immediate medical attention. Emergency departments (EDs) with high volumes of sepsis cases have the lowest odds of inpatient mortality for these patients, concludes a new study. Researchers reviewed the records of 87,166 adults with sepsis who were admitted to 551 hospitals after receiving care in the ED. Hospitals were categorized into quartiles based on the volume of sepsis patients treated in their EDs. Key outcome measures were death at any time during hospital admission and early inpatient mortality during the first 2 days of admission.
The overall inpatient mortality rate was 18.0 percent; early inpatient mortality was 6.9 percent. Annual ED sepsis volume quartiles were the following: 25 to 145 patients, 146 to 248, 249 to 371, and 372 or more. Patients admitted to hospitals in the highest volume quartile had 27 percent lower odds of dying while in the hospital and 31 percent lower odds of early inpatient mortality. According to the researchers, early inpatient mortality likely more closely reflects the quality of care received by patients with sepsis in the ED before their admission.
The results of this study support further investigation into sepsis treatment best practices in the ED, particularly those found in larger volume hospitals. Educational programs and operational interventions could be designed and translated from these hospitals to improve care at low-sepsis-volume hospitals. The study was supported in part by the Agency for Healthcare Research and Quality (T32 HS00078).
See " Volume of emergency department admissions for sepsis is related to inpatient mortality: Results of a nationwide cross-sectional analysis," by Emilie S. Powell, M.D., M.B.A., Rahul K. Khare, M.D., D. Mark Courtney, M.D., and Joe Feinglass, Ph.D., in the November 2010 Critical Care Medicine 38(11), pp. 2161-2168.