Inpatient study: Hospital costs two-fold higher for sepsis patients diagnosed after admission

Findings from a retrospective analysis of inpatient data recently published in Critical Care Medicine show that average hospital costs and mortality rates are significantly higher for patients diagnosed with sepsis after hospital admission when compared with patients diagnosed prior to admission.

Physician researchers at Beckman Coulter conducted a retrospective analysis of patient health information to characterize the burden, outcomes, and costs of managing sepsis in the U.S. They conducted their analysis using patient data from the Premier Healthcare Database, which represents approximately 20% of U.S. inpatient discharges among private and academic hospitals.

Researchers reviewed claims for adults over 18 years of age hospitalized for sepsis and discharged between January 1, 2016, and September 30, 2016. They collected data on mortality rates, length of stay, and treatment costs for 2,566,689 selected cases.

To characterize the economic burden of sepsis by severity level, they organized cases into severity categories based on documented ICD-9 and ICD-10 diagnosis codes and determined average hospital costs and mortality rates for patients in each category.

Cases with septic shock codes (e.g., R65.21 [severe sepsis with septic shock], T81.12XA [postprocedural septic shock, initial encounter]) were classified as septic shock cases; cases with severe sepsis but no septic shock codes (e.g., R65.20 [severe sepsis without septic shock]) were classified as severe sepsis; those with sepsis codes but no severe sepsis or septic shock codes (e.g., [A40.-, Streptococcal sepsis]) were classified as sepsis without organ dysfunction; all other cases were classified as other. Researchers then stratified inpatients into two overarching categories: patients with sepsis present on admission and those with sepsis not present on admission.

Overall, findings showed that mortality rates and healthcare resource costs increased as severity level increased. Patients diagnosed after being admitted spent nearly double the amount of time in the hospital, in the intensive care unit, and/or on mechanical ventilation when compared to patients who presented with sepsis on admission. Average treatment costs and mortality rates were much higher for patients diagnosed with sepsis after being hospitalized, as evidenced in the table below.

Sepsis Hospitalization Costs, Mortality Rates