News: Clinical sepsis data from EHRs may be better than claims data
Claims-based data suggest that the incidence of sepsis is increasing and mortality rates from sepsis are decreasing, but a new study led by researchers at Brigham and Women’s Hospital in Boston challenges that assertion.
The study’s findings, published in the Journal of the American Medical Association (JAMA), challenge the use of claims data for sepsis surveillance and suggest that clinical surveillance using EHR data provides more objective estimates of sepsis incidence and outcomes, HealthLeaders Media reported.
“Estimates from claims data may lack clinical fidelity and can be affected by changing diagnosis and coding practices over time,” the researchers wrote.
The research team developed a new strategy to track sepsis incidence and outcomes using electronic clinical data instead of insurance claims. Sepsis was identified if a patient had concurrent indicators of infection and organ dysfunction—criteria adapted from Sepsis-3.
The researchers applied this definition to EHR data from nearly three million patients admitted to 409 U.S. hospitals in 2014; they found that sepsis was present in 6% of all hospitalizations and in more than one in three hospitalizations that ended in death.
These data were used to project the total burden of sepsis in hospitalized patients in 2014. They estimated that there were approximately 1.7 million sepsis cases nationwide in 2014, of whom 270,000 died.
In addition, the researchers assessed whether sepsis incidence and outcomes have been changing over time and in contrast to prior claims-based estimates, they found no significant changes in adult sepsis incidence or in the combined outcome of death or discharge to hospice between 2009 and 2014.
Editor’s note: This article appeared originally in HealthLeaders Media. To read the entire study published in JAMA, click here. To read about Sepsis-3 criteria, click here. To read an ACDIS White Paper on the topic of sepsis definitions and CDI’s role, click here.