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. 2017 Jun 9;7(6):e014885.
doi: 10.1136/bmjopen-2016-014885.

Defining and measuring suspicion of sepsis: an analysis of routine data

Matthew Inada-Kim  1 , Bethan Page  2 , Imran Maqsood  3 , Charles Vincent  2
Affiliations

Defining and measuring suspicion of sepsis: an analysis of routine data

Matthew Inada-Kim et al. BMJ Open. .

Abstract

Objectives: To define the target population of patients who have suspicion of sepsis (SOS) and to provide a basis for assessing the burden of SOS, and the evaluation of sepsis guidelines and improvement programmes.

Design: Retrospective analysis of routinely collected hospital administrative data.

Setting: Secondary care, eight National Health Service (NHS) Acute Trusts.

Participants: Hospital Episode Statistics data for 2013-2014 was used to identify all admissions with a primary diagnosis listed in the 'suspicion of sepsis' (SOS) coding set. The SOS coding set consists of all bacterial infective diagnoses.

Results: We identified 47 475 admissions with SOS, equivalent to a rate of 17 admissions per 1000 adults in a given year. The mortality for this group was 7.2% during their acute hospital admission. Urinary tract infection was the most common diagnosis and lobar pneumonia was associated with the most deaths. A short list of 10 diagnoses can account for 85% of the deaths.

Conclusions: Patients with SOS can be identified in routine administrative data. It is these patients who should be screened for sepsis and are the target of programmes to improve the detection and treatment of sepsis. The effectiveness of such programmes can be evaluated by examining the outcomes of patients with SOS.

Keywords: epidemiology; improvement programmes; sepsis; suspicion of sepsis.

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Conflict of interest statement

Competing interests: MIK reports grants for roles as clinical lead for sepsis across Oxford Academic Health Science Network and clinical lead of the Patient Safety Collaborative, Wessex. BP and IM declare no competing interests. CV declares grants from Oxford Academic Health Science Network, during the conduct of the study and occasional consultancy work on patient safety unrelated to this project.

Figures

Figure 1.
Figure 1.
Suspicion of sepsis admissions and mortality by age and gender.
Figure 2.
Figure 2.
Top 10 'Suspicion of Sepsis' diagnoses associated with death.
See this image and copyright information in PMC

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