Sepsis trends: increasing incidence and decreasing mortality, or changing denominator?

Journal of Thoracic Disease
Chanu Rhee, Michael Klompas

Abstract

Numerous studies suggest that the incidence of sepsis has been steadily increasing over the past several decades while mortality rates are falling. However, reliably assessing trends in sepsis epidemiology is challenging due to changing diagnosis and coding practices over time. Ongoing efforts by clinicians, administrators, policy makers, and patient advocates to increase sepsis awareness, screening, and recognition are leading to more patients being labeled with sepsis. Subjective clinical definitions and heterogeneous presentations also allow for wide discretion in diagnosing sepsis rather than specific infections alone or non-specific syndromes. These factors create a potential ascertainment bias whereby the inclusion of less severely ill patients in sepsis case counts over time leads to a perceived increase in sepsis incidence and decrease in sepsis mortality rates. Analyses that rely on administrative data alone are further confounded by changing coding practices in response to new policies, financial incentives, and efforts to improve documentation. An alternate strategy for measuring sepsis incidence, outcomes, and trends is to use objective and consistent clinical criteria rather than administrative codes or registries ...Continue Reading

Citations

Jul 22, 2020·The Journal of Infectious Diseases·Claire N ShappellChanu Rhee
Feb 29, 2020·BMJ Quality & Safety·Claire N Shappell, Chanu Rhee
Jun 17, 2020·Fetal and Pediatric Pathology·Mohammad Hosein JarahzadehHossein Neamatzadeh
Nov 16, 2020·Acta Anaesthesiologica Scandinavica·Maria LengquistAttila Frigyesi
Jan 12, 2021·Journal of Critical Care·Gabriel WardiAngela Meier
Jan 26, 2021·Current Opinion in Anaesthesiology·Catherine Chiu, Matthieu Legrand
Jan 21, 2021·Current Opinion in Anaesthesiology·Salvatore Lucio CutuliMassimo Antonelli
Apr 4, 2021·Biomedicines·Kieran LeongMichael T McCurdy
Jun 5, 2021·JMIR Medical Informatics·Jewel Y LeeJennifer J Hadlock
Jul 25, 2021·Scientific Reports·Ann-Charlotte LindströmEmma Larsson

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