Table 1.
Patient characteristics and unadjusted outcomes among ward patients with hospital-acquired sepsis using the Centers for Disease Control and Prevention Adult Sepsis Event and Third International Consensus Definition for Sepsis criteria
| CDC ASE | Sepsis-3 | |
|---|---|---|
| No. of subjects | 1,672 | 3,883 |
| Patient characteristics | ||
| Hospital of admission | ||
| 1 | 1,221 (73) | 2,556 (66) |
| 2 | 215 (13) | 562 (14) |
| 3 | 122 (7) | 416 (11) |
| 4 | 69 (4) | 213 (5) |
| 5 | 45 (3) | 136 (4) |
| Admission year | ||
| 2017 | 314 (19) | 760 (20) |
| 2018 | 680 (41) | 1,577 (41) |
| 2019 | 678 (41) | 1,546 (40) |
| Age | 63 (54–71) | 65 (55–73) |
| Male | 910 (54) | 2,109 (54) |
| Race | ||
| White | 1,095 (66) | 2,399 (62) |
| Black | 428 (26) | 1,128 (29) |
| Other* | 149 (9) | 356 (9) |
| Latinx | 45 (3) | 114 (3) |
| Admission diagnosis category | ||
| Symptoms, signs, and abnormal clinical and laboratory findings, NOS | 456 (27) | 1,153 (30) |
| Neoplasms | 291 (17) | 579 (15) |
| Diseases of the circulatory system | 175 (10) | 430 (11) |
| Diseases of the digestive system | 152 (9) | 305 (8) |
| Certain infectious and parasitic diseases | 119 (7) | 281 (7) |
| Injury, poisoning, and certain other consequences of external causes | 97 (6) | 232 (6) |
| Factors influencing health status and contact with health services | 86 (5) | 145 (4) |
| Diseases of the respiratory system | 62 (4) | 137 (4) |
| Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism | 57 (3) | 142 (4) |
| Endocrine, nutritional, and metabolic diseases | 50 (3) | 121 (3) |
| Diseases of the musculoskeletal system and connective tissue | 46 (3) | 135 (3) |
| Diseases of the genitourinary system | 36 (2) | 80 (2) |
| Diseases of the nervous system | 23 (1) | 73 (2) |
| Other† | 22 (1) | 70 (2) |
| Medicine service at time of sepsis onset | 1,372 (82) | 3,208 (83) |
| Days from admission to sepsis onset | 7.3 (3.8–12.7) | 5.8 (3.2–10.5) |
| Sequential Organ Failure Assessment | ||
| At sepsis onset | 4 (2–6) | 4 (2–5) |
| Maximum during sepsis‡ | 8 (5–12) | 6 (4–9) |
| Vasopressors | ||
| At sepsis onset‡ | 29 (2) | 31 (1) |
| Any time during sepsis episode§ | 711 (43) | 979 (25) |
| Mechanical ventilation | ||
| At sepsis onset‡ | 58 (3) | 48 (1) |
| Any time during sepsis episode§ | 612 (37) | 806 (21) |
| Exposure | ||
| No. of ward locations | 43 | 50 |
| SD of standardized ward census,‖ range | 0.85–8.07 | 0.85–8.07 |
| SD of standardized ward census‖ | 2.40 (1.87–3.09) | 2.41 (1.89–3.14) |
| Outcomes | ||
| Time to antimicrobials from sepsis onset, h | 4.1 (0.4–23.3) | 11.3 (2.2–29.3) |
| Received antimicrobials within 1 h of sepsis onset | 479 (29) | 680 (18) |
| Received antimicrobials within 3 h of sepsis onset | 751 (45) | 1,159 (30) |
| In-hospital mortality | 320 (19) | 572 (15) |
Definition of abbreviations: CDC ASE = Centers for Disease Control and Prevention Adult Sepsis Event; IQR = interquartile range; NOS = not otherwise specified; Sepsis-3 = Third International Consensus Definition for Sepsis; SD = standard deviation.
All values presented as n (%) or median (IQR) unless otherwise specified.
Other: Asian, American Indian or Alaskan Native, Pacific Islander, mixed, unknown, other.
Other: mental, behavioral, and neurodevelopmental disorders; diseases of the eye and adnexa; diseases of the ear and mastoid process; pregnancy, childbirth, and the puerperium; diseases of the skin and subcutaneous tissue; congenital malformations, deformations, and chromosomal abnormalities. Each of these diagnoses represented <1% of the overall population and was derived from International Classification of Diseases-Tenth codes.
Includes new start of vasopressors or mechanical ventilation concurrent with sepsis onset.
Sepsis episode: period from sepsis onset to end of antimicrobial therapy.
Standardized for each unit by quarter and year; clinically, SD represents the change in number of patients in a ward.