CHEST Guidelines-Septic-Shock-Surveillance

Septic-Shock-Surveillance_chest

Pdf Summary

Septic shock poses a significant health-care burden due to its high costs and contribution to morbidity and mortality in hospitals. Between 1980 and 2000, sepsis cases tripled, becoming the most expensive and common condition in intensive care. Consequently, Medicare and Medicaid Services have integrated sepsis care into their performance measurements to improve treatment outcomes.<br /><br />Researchers have raised concerns about the reliance on administrative billing data, which may inaccurately reflect sepsis incidence and mortality trends due to changes in billing practices over time. A study by Kadri and colleagues analyzed 6.5 million hospitalizations to assess septic shock incidence and mortality between 2005 and 2014 using a clinical algorithm, contrasting it with ICD-9-CM billing codes. Their approach involved tracking blood culture orders, antibiotic administration, and vasopressor support. They found that septic shock incidence and mortality increased at a lower rate based on the clinical definition compared to billing codes. The study revealed a higher sensitivity in the clinical definition than in the billing code, while the latter displayed greater specificity.<br /><br />Despite the improved recognition and coding of septic shock over the study period, the modest decline in mortality in this specific patient cohort indicates that ongoing efforts are necessary to enhance outcomes. The study also highlighted discrepancies in septic shock identification between clinical definitions and administrative codes, leading to varying incidence and mortality rates.<br /><br />Given the significant number of patients who might be misclassified, accurate data collection and improved methods for identifying septic shock in later electronic health records are critical. These improvements are essential to ensure appropriate treatment and accurate hospital performance assessment in managing septic shock patients.

Keywords

septic shock

health-care burden

morbidity

mortality

sepsis incidence

billing data

clinical algorithm

ICD-9-CM codes

hospital performance

electronic health records