Increasing Sepsis Rates in the United States: Results From National Inpatient Sample, 2005 to 2014

Area of Science:

• Public Health
• Epidemiology
• Healthcare Management

Background:

• Sepsis remains a significant global health challenge with substantial morbidity and mortality.
• Understanding temporal trends in sepsis epidemiology is crucial for effective resource allocation and public health interventions.

Purpose of the Study:

• To analyze trends in sepsis hospitalization rates, mortality, and associated costs between 2005 and 2014.
• To identify changes in sepsis care outcomes over a decade.

Main Methods:

• Retrospective serial cross-sectional analysis of adult patients (≥18 years) admitted for sepsis.
• Utilized the National Inpatient Sample database for data extraction.
• Calculated age- and sex-adjusted rates for hospitalizations and costs.

Main Results:

• Sepsis hospitalizations more than doubled, increasing from 541,694 in 2005 to 1,338,905 in 2014.
• The overall sepsis hospitalization rate rose from 1.2% to 2.7% (123.8% relative increase).
• Despite increased total costs, mean hospitalization costs significantly decreased from $46,470 to $29,290.

Conclusions:

• Hospitalizations for sepsis markedly increased between 2005 and 2014.
• Paradoxically, in-hospital mortality, length of stay, and mean hospitalization costs for sepsis showed a declining trend.
• Potential biases from coding rules (ICD-9-CM), increased readmissions, or improved awareness/surveillance may explain these findings; standardized registries are recommended.