Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA.
Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL, USA.
J Intensive Care Med. 2020 Sep;35(9):858-868. doi: 10.1177/0885066618794136. Epub 2018 Sep 2.
To examine the trends in hospitalization rates, mortality, and costs for sepsis during the years 2005 to 2014.
This was a retrospective serial cross-sectional analysis of patients ≥18 years admitted for sepsis in National Inpatient Sample. Trends in sepsis hospitalizations were estimated, and age- and sex-adjusted rates were calculated for the years 2005 to 2014.
There were 541 694 sepsis admissions in 2005 and increased to 1 338 905 in 2014. Sepsis rates increased significantly from 1.2% to 2.7% during the years 2005 to 2014 (relative increase: 123.8%; < .001). However, the relative increase changed by 105.8% ( < .001) after adjusting for age and sex and maintained significance. Although total cost of hospitalization due to sepsis increased significantly from US$22.2 to US$38.1 billion ( < .001), the mean hospitalization cost decreased significantly from US$46,470 to US$29,290 ( < .001).
Hospitalizations for sepsis increased during the years 2005 to 2014. Our study paradoxically found declining rates of in-hospital mortality, length of stay, and mean hospitalization cost for sepsis. These findings could be due to biases introduced by coding rules and increased readmission rates or alternatively due to increased awareness and surveillance and changing disposition status. Standardized epidemiologic registries should be developed to overcome these biases.
研究 2005 年至 2014 年脓毒症住院率、死亡率和费用的趋势。
这是一项对国家住院患者样本中≥18 岁因脓毒症住院患者的回顾性连续横断面分析。对脓毒症住院的趋势进行了估计，并计算了 2005 年至 2014 年的年龄和性别调整率。
2005 年有 541694 例脓毒症入院，2014 年增至 1338905 例。2005 年至 2014 年，脓毒症发病率从 1.2%显著上升至 2.7%（相对增加：123.8%；<0.001）。然而，调整年龄和性别后，相对增加率变化了 105.8%（<0.001），仍具有统计学意义。尽管因脓毒症住院的总费用从 222 亿美元显著增加至 3810 亿美元（<0.001），但平均住院费用从 46470 美元显著下降至 29290 美元（<0.001）。
2005 年至 2014 年，脓毒症住院人数增加。我们的研究发现，住院死亡率、住院时间和脓毒症平均住院费用呈下降趋势，这与预期相反。这些发现可能是由于编码规则引入的偏倚和再入院率的增加，或者是由于对脓毒症的认识和监测的提高以及处置状态的改变。应该制定标准化的流行病学登记来克服这些偏见。
