In-Hospital Sepsis Mortality Rates Comparing Tertiary and Non-Tertiary Hospitals in Washington State.

Area of Science:

• Healthcare outcomes research
• Hospital quality and safety
• Epidemiology of infectious diseases

Background:

• Sepsis affects over a million Americans annually and is a leading cause of in-hospital death.
• Unlike other critical conditions, sepsis care is not technology-dependent, suggesting care quality may vary by hospital type.
• Understanding disparities in sepsis outcomes is vital for improving patient survival.

Purpose of the Study:

• To compare sepsis-related mortality rates between tertiary and non-tertiary hospitals in Washington State.
• To identify potential differences in sepsis care outcomes across different hospital settings.
• To inform strategies for reducing sepsis mortality nationwide.

Main Methods:

• Retrospective longitudinal observational cohort study.
• Analysis of 86,378 adult sepsis patient records from 73 Washington State hospitals (2010-2015).
• Inclusion of all tertiary (7) and non-tertiary (66) hospitals, data from a standardized state database.

Main Results:

• Overall hospital mortality rate for sepsis was 6.5%.
• Non-tertiary hospitals showed a significantly higher odds ratio for in-hospital death compared to tertiary hospitals (OR 1.25, 95% CI 1.17-1.35, p < 0.001).
• The adjusted analysis confirmed increased mortality risk in non-tertiary settings.

Conclusions:

• Sepsis mortality rates are demonstrably higher in non-tertiary hospitals than in tertiary facilities.
• Given that most sepsis patients are treated outside tertiary centers, understanding this mortality difference is crucial.
• Further research is essential to pinpoint the causes of this disparity and improve sepsis care in all hospital types.