Hospital-Onset Sepsis Warrants Expanded Investigation and Consideration as a Unique Clinical Entity.

Area of Science:

• Critical Care Medicine
• Infectious Diseases
• Health Services Research

Background:

• Sepsis is a leading cause of death in hospitalized adults.
• A significant proportion of sepsis cases develop during hospitalization (hospital-onset sepsis, HOS).
• Hospital-onset sepsis (HOS) is associated with worse clinical outcomes and higher costs compared to community-onset sepsis (COS).

Purpose of the Study:

• To identify knowledge gaps in the recognition and management of HOS in adults.
• To propose research priorities for investigating HOS.
• To improve care and outcomes for patients with HOS.

Main Methods:

• This study outlines knowledge gaps and proposes research priorities.
• It involves a review of existing literature and expert consensus on HOS.
• Focuses on identifying areas for future clinical and research endeavors.

Main Results:

• Patients with HOS experience more mechanical ventilation, ICU admission, longer stays, higher costs, and increased mortality than COS patients.
• Significant differences exist in comorbidities, diagnosis, clinical presentation, and illness severity between HOS and COS patients.
• HOS patients remain understudied despite their distinct characteristics and poorer outcomes.

Conclusions:

• Expanded investigation into HOS is warranted due to its significant impact.
• Key research priorities include standardizing case identification, understanding heterogeneity, developing tailored management, and identifying prevention strategies.
• Addressing disparities and ensuring goal-concordant care are critical for improving HOS outcomes.