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Penn study: Sepsis patients fare better in hospitals with higher case volumes
Date:9/3/2014

flow. Not only is severe sepsis becoming more common, but the in-hospital mortality rate can be as high as 38 percent, and the illnesses costs the United States health system approximately $24 billion annually. The Centers for Disease Control and Prevention (CDC) currently lists septicemia as the 11th leading cause of death in the U.S., and the burden is expected to increase as the population ages.

The recent Penn study looked at hospital admissions examining the relationship between annual case volume, urban location, organ dysfunction and survival over a seven year period (2004-2010) among a total of 914,200 patients with severe sepsis, culled from the largest national database of publically available inpatient information. The study found an inverse relationship between severe sepsis case volume and inpatient mortality, in both urban and rural hospitals. Overall in-hospital mortality was 28 percent, but the study found that patients treated at higher-volume hospitals (those who treated 500 or more cases per year) had a 36 percent increase in their odds of inpatient survival compared to those treated at lower-volume hospitals (less than 50 cases per year). Typically, the highest volume hospitals are academic medical centers, which tend to be located in urban areas.

The study also examined the association between inpatient severe sepsis mortality and organ dysfunction type, finding that the most common organ system dysfunctions were renal, respiratory and cardiovascular. Additionally, the study found that mortality from severe sepsis increased as the number of organ dysfunctions increased.

Severe sepsis treatment efforts in the Hospital of the University of Pennsylvania's (HUP) emergency department have been focused on early measurement of serum lactate which can help indicate whether enough oxygen is being delivered to tissues in the body as a marker of impending shock. The results are then used to identify potentially critically ill
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Contact: Anna Duerr
anna.duerr@uphs.upenn.edu
215-349-8369
University of Pennsylvania School of Medicine
Source:Eurekalert

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