CDC National Sepsis Survey using EHR Data
Sepsis is a leading cause of death, disability, and cost worldwide. Given sepsis’ high prevalence, it’s devastating morbidity and mortality, and ongoing high profile initiatives to improve sepsis detection and care there is a critical need for better measures of sepsis incidence, trends, and outcomes. The increasing national penetration of electronic health record (EHR) systems allows for the possibility of tracking sepsis using objective clinical markers of infection and organ dysfunction rather than subjective and changing administrative code assignments. The Epicenters developed EHR-based surveillance definitions for sepsis and demonstrated that they have superior sensitivity, similar positive predictive value, and more stable sensitivity over time compared to claims data. In this project, we extended this work by applying these definitions to a broad national network of hospitals in order to generate accurate and generalizable estimates of sepsis burden and epidemiology.
More specifically, working with our collaborators, our aims were to 1) Estimate the current national burden of sepsis and septic shock using electronic clinical data from a broad coalition of academic, community, and veterans’ hospitals distributed throughout the United States, and 2) Characterize trends in sepsis incidence and mortality using electronic clinical data from diverse hospitals.
Rhee C, Dantes R, Epstein L, Murphy DJ, Seymour CW, Iwashyna TJ, Kadri SS, Angus DC, Danner RL, Fiore AE, Jernigan JA, Martin GS, Septimus E, Warren DK, Karcz A, Chan C, Menchaca JT, Wang R, Gruber S, Klompas M. Incidence and Trends of Sepsis in US Hospitals Using Clinical vs Claims Data, 2009-2014. JAMA. 2017 Sep 13. PMID: 28903154.
Evaluation and Comparison of Sepsis Definitions
In this project, along with our collaborators at the University of Washington in St. Louis and Duke University, we plan to: 1) Evaluate and compare the clinical characteristics, associated morbidity and mortality, and overlap of the new SCCM/ESICM sepsis clinical definition, the proposed Epicenters’ EHR-based sepsis surveillance definition, and sepsis administrative claims definitions, 2) Determine the attributable mortality of hospital-onset sepsis and identify the associated clinical characteristics and comorbidities of patients who die from sepsis, and 3) Quantify interobserver variability in assessing compliance with the CMS sepsis measure.
Principal Investigators: Richard Platt, MD, MSc, Michael Klompas, MD, MPH, Chanu Rhee, MD, MPH