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Resource Utilization Among Patients With Sepsis Syndrome

Published online by Cambridge University Press:  02 January 2015

David W. Bates ,
D. Tony Yu ,
Edgar Black ,
Kenneth E. Sands ,
J. Sanford Schwartz ,
Patricia L. Hibberd ,
Paul S. Graman ,
Paul N. Lanken ,
Katherine L. Kahn  and
David R. Snydman
...Show all authors
David W. Bates*
Affiliation:
Division of General Medicine, Brigham and Women's Hospital, Boston, Massachusetts
D. Tony Yu
Affiliation:
Division of General Medicine, Brigham and Women's Hospital, Boston, Massachusetts
Edgar Black
Affiliation:
Division of General Internal Medicine, Department of Medicine, University of Rochester School of Medicine, Rochester, New York
Kenneth E. Sands
Affiliation:
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
J. Sanford Schwartz
Affiliation:
Division of General Internal Medicine, Department of Medicine, and the Leonard Davis Institute, University of Pennsylvania, Philadelphia, Pennsylvania
Patricia L. Hibberd
Affiliation:
Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
Paul S. Graman
Affiliation:
Infectious Diseases Unit, Department of Medicine, University of Rochester School of Medicine, Rochester, New York
Paul N. Lanken
Affiliation:
Pulmonary and Critical Care Division, Department of Medicine, and the Leonard Davis Institute, University of Pennsylvania, Philadelphia, Pennsylvania
Katherine L. Kahn
Affiliation:
Division of General Internal Medicine, University of California at Los Angeles Medical Center, Los Angeles, California
David R. Snydman
Affiliation:
Division of Infectious Diseases, Department of Medicine and Pathology, New England Medical Center andTufts University School of Medicine, Boston, Massachusetts
Jeffrey Parsonnet
Affiliation:
Infectious Disease Section, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
Richard Moore
Affiliation:
Division of Infectious Diseases, Johns Hopkins Hospital, Baltimore, Maryland
Richard Platt
Affiliation:
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts Department of Ambulatory Care and Prevention, Harvard Medical School, Boston, Massachusetts
*
Division of General Medicine, Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115
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Abstract

Objective:

To assess the resource utilization associated with sepsis syndrome in academic medical centers.

Design:

Prospective cohort study.

Setting:

Eight academic, tertiary-care centers.

Patients:

Stratified random sample of 1,028 adult admissions with sepsis syndrome and all 248,761 other adult admissions between January 1993 and April 1994. The main outcome measures were length of stay (LOS) in total and after onset of sepsis syndrome (post-onset LOS) and total hospital charges.

Results:

The mean LOS for patients with sepsis was 27.7 ± 0.9 days (median, 20 days), with sepsis onset occurring after a mean of 8.1 ± 0.4 days (median, 3 days). For all patients without sepsis, the LOS was 7.2 ± 0.03 days (median, 4 days). In multiple linear regression models, the mean for patients with sepsis syndrome was 18.2 days, which was 11.0 days longer than the mean for all other patients (P < .0001), whereas the mean difference in total charges was $43,000 (both P < .0001). These differences were greater for patients with nosocomial as compared with community-acquired sepsis, although the groups were similar after adjusting for pre-onset LOS. Eight independent correlates of increased post-onset LOS and 12 correlates of total charges were identified.

Conclusions:

These data quantify the resource utilization associated with sepsis syndrome, and demonstrate that resource utilization is high in this group. Additional investigation is required to determine how much of the excess post-onset LOS and charges are attributable to sepsis syndrome rather than the underlying medical conditions.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 1 , January 2003 , pp. 62 - 70
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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