Sepsis-Associated Mortality, Resource Use, and Healthcare Costs: A Propensity-Matched Cohort Study.
Objectives: To examine long-term mortality, resource utilization, and healthcare costs in sepsis patients compared to hospitalized nonsepsis controls.Design: Propensity-matched population-based cohort study using administrative data.Setting: Ontario, Canada.Patients: We identified a cohort of adults...
| Publicado en: | Critical Care Medicine Vol. 49; no. 2; pp. 215 - 228 |
|---|---|
| Autores principales: | , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Feb2021
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=148736274&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 148736274 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00903493 04O jtl: Critical Care Medicine issn: 00903493 maglogo: N pubinfo: dt: Feb2021 vid: 49 iid: 2 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 148736274 148736274 NLM33372748 148736274 10.1097/CCM.0000000000004777 NLM33372748 148736274 ppf: 215 ppct: 13 formats: tig: atl: Sepsis-Associated Mortality, Resource Use, and Healthcare Costs: A Propensity-Matched Cohort Study. aug: au: Farrah, Kelly McIntyre, Lauralyn Doig, Christopher J. Talarico, Robert Taljaard, Monica Krahn, Murray Fergusson, Dean Forster, Alan J. Coyle, Doug Thavorn, Kednapa affil: School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada. sug: subj: Patient Discharge Economics Intensive Care Units Economics Sepsis Mortality Sepsis Economics After Care Economics Hospital Mortality Trends Male Middle Age Insurance Coverage Statistics and Numerical Data Human Aged Adult Readmission Economics Ontario Prospective Studies Sepsis Therapy Cox Proportional Hazards Model Probability Cross Infection Economics Comparative Studies Multicenter Studies Evaluation Research Validation Studies Middle Aged: 45-64 years Aged: 65+ years Adult: 19-44 years Male ab: Objectives: To examine long-term mortality, resource utilization, and healthcare costs in sepsis patients compared to hospitalized nonsepsis controls.Design: Propensity-matched population-based cohort study using administrative data.Setting: Ontario, Canada.Patients: We identified a cohort of adults (≥ 18) admitted to hospitals in Ontario between April 1, 2012, and March 31, 2016, with follow-up to March 31, 2017. Sepsis patients were flagged using a validated International Classification of Diseases, 10th Revision-coded algorithm (Sepsis-2 definition), including cases with organ dysfunction (severe sepsis) and without (nonsevere). Remaining hospitalized patients were potential controls. Cases and controls were matched 1:1 on propensity score, age, sex, admission type, and admission date.Interventions: None.Measurements and Main Results: Differences in mortality, rehospitalization, hospital length of stay, and healthcare costs were estimated, adjusting for remaining confounders using Cox regression and generalized estimating equations. Of 270,669 sepsis cases, 196,922 (73%) were successfully matched: 64,204 had severe and 132,718 nonsevere sepsis (infection without organ dysfunction). Over follow-up (median 2.0 yr), severe sepsis patients had higher mortality rates than controls (hazard ratio, 1.66; 95% CI, 1.63-1.68). Both severe and nonsevere sepsis patients had higher rehospitalization rates than controls (hazard ratio, 1.53; 95% CI, 1.50-1.55 and hazard ratio, 1.41; 95% CI, 1.40-1.43, respectively). Incremental costs (Canadian dollar 2018) in sepsis cases versus controls at 1-year were: $29,238 (95% CI, $28,568-$29,913) for severe and $9,475 (95% CI, $9,150-$9,727) for nonsevere sepsis.Conclusions: Severe sepsis was associated with substantially higher long-term risk of death, rehospitalization, and healthcare costs, highlighting the need for effective postdischarge care for sepsis survivors. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|