Table 1.
Demographic Characteristics and Outcomes of 16,124 Subjects who met SIRS-first or SOFA-first
| Variable | SIRS-first n=9,087 | SOFA-first n=7,037 | p-value |
|---|---|---|---|
| Age at presentation (median, interquartile range) | 59 (44, 73) | 65 (54, 79) | <0.0001 |
| Female | 4,352 (47.9) | 3,257 (46.3) | 0.042 |
| Race | 0.006 | ||
| White | 4,077 (44.9) | 3,310 (47.0) | |
| Asian | 2,131 (23.5) | 1,507 (21.4) | |
| Black | 1,640 (18.1) | 1,296 (18.4) | |
| Other | 1,239 (13.6) | 924 (13.1) | |
| Payer type | <0.0001 | ||
| Medicare | 4,325 (47.6) | 4,274 (60.7) | |
| Medi-Cal | 2,324 (25.6) | 1,505 (21.4) | |
| Commercial | 2,232 (24.6) | 1,160 (16.5) | |
| Other/Self-Pay | 206 (2.3) | 98 (1.4) | |
| Chronic renal failurea | 1,512 (16.6) | 2,067 (29.4) | <0.0001 |
| Chronic liver diseasea | 942 (10.4) | 1,280 (18.2) | <0.0001 |
| Cancera | |||
| Lymphoma | 326 (3.6) | 210 (3.0) | 0.034 |
| Solid tumor | 963 (10.6) | 741 (10.5) | 0.890 |
| Metastatic cancer | 948 (10.4) | 617 (8.8) | <0.0001 |
| van Walraven Comorbidity Index value (median, interquartile range) | 7 (0, 15) | 10 (4, 17) | <0.0001 |
| Admission level of care | <0.0001 | ||
| Discharged from ED | 420 (4.6) | 189 (2.7) | |
| Admission to outside facility | 129 (1.4) | 72 (1.0) | |
| Acute care | 4,930 (54.3) | 4,386 (62.3) | |
| Stepdown care | 2,225 (24.5) | 1,426 (20.3) | |
| Intensive care | 1,383 (15.2) | 964 (13.7) | |
| Year of ED encounterb | 0.359 | ||
| 2012 | 964 (10.6) | 694 (9.9) | |
| 2013 | 1,936 (21.3) | 1,449 (20.6) | |
| 2014 | 1,952 (21.5) | 1,541 (21.9) | |
| 2015 | 2,164 (23.8) | 1,718 (24.4) | |
| 2016 | 2,071 (22.8) | 1,635 (23.2) | |
| Time to antibiotics in hours (median, interquartile range) | 2.7 (1.5, 4.9) | 4.1 (2.3, 7.9) | <0.0001 |
| Positive blood culture | 564 (6.2) | 309 (4.4) | <0.0001 |
| Receipt of validated sepsis discharge codec | 3,383 (37.2) | 1,621 (23.0) | <0.0001 |
| Site of infection coded on discharge | <0.0001 | ||
| None coded | 3,128 (34.4) | 2,660 (37.8) | |
| Skin and soft tissue infection | 592 (6.5) | 563 (8.0) | |
| Urinary tract infection | 523 (5.8) | 683 (9.7) | |
| Pneumonia | 1,237 (13.6) | 863 (12.3) | |
| Bacteremia | 837 (9.2) | 437 (6.2) | |
| Sepsis | 412 (4.5) | 208 (3.0) | |
| Otherd | 408 (4.5) | 426 (6.1) | |
| Multiple sites | 1,950 (21.5) | 1,197 (17.0) | |
| In-hospital mortality | 579 (6.4) | 479 (6.8) | 0.268 |
| ICU length of stay among survivors (median, interquartile range)e | 2.8 (1.7,5.1) | 3.0 (1.8,5.1) | 0.138 |
| Vasopressor receipt | 675 (7.4) | 560 (8.0) | 0.210 |
| Receipt of mechanical ventilation | 741 (8.2) | 606 (8.6) | 0.302 |
Defined using the Elixhauser comorbidity ICD-9/10 grouping method
Study period was June 1, 2012-December 31, 2016
Codes included ICD-10: A02.1, A22.7, A26.7, A32.7, A40.0, A40.1, A40.3, A40.8, A40.9, A41.01, A41.02, A41.1, A41.2, A41.3, A41.4, A41.50, A41.51, A41.52, A41.53, A41.59, A41.81, A41.89, A41.9, A42.7, A54.86, B37.7, R65.20, R65.2; ICD-9: 038.0, 038.1, 038.11, 038.12, 038.19, 038.2, 038.3, 038.4, 038.41, 038.42, 038.43, 038.44, 038.49, 038.8, 038.9, 995.91, 995.92.
Other sites included osteomyelitis, meningitis, peritonitis, Clostridium difficile infection, biliary infection, and device related infection
There were 1,636 SIRS-first and 1,209 SOFA-first patients who survived and were ever admitted to the ICU.