Patient safety and outcomes in sepsis

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DESCRIPTION (provided by applicant): Sepsis is the 10th leading cause of death in the United States and accounts for more than 1 in 50 hospitalizations. Increasing in both incidence and severity, sepsis is also associated with extremely high in-hospital mortality rates, increased risks of death among survivors, and considerable use of healthcare resources. Current guidelines focus on improving the delivery and quality of sepsis care through protocol-based interventions aimed at improving mortality, decreasing complication rates, and reducing healthcare utilization and cost. While preliminary studies suggest that critically ill patients are vulnerable to iatrogenic adverse events, no studies have defined the association of patient safety and outcomes in sepsis patients nationally. By utilizing data available in the Healthcare Cost and Utilization Project National Inpatient Sample and evaluating the Agency for Healthcare Research and Quality's Patient Safety Indicators (PSI), the proposed study will provide novel insight into the association between patient safety and sepsis outcomes on a national level. First, the study will define the incidence of complications among patients with sepsis by evaluating the rate of PSI events and determine whether sepsis patients are at increased risk compared with the general hospital population. Second, it will describe the excess mortality, length of stay, and hospital cost associated with PSI events by multivariable case matching techniques. Finally, it will evaluate whether hospital-level measures of patient safety are associated with sepsis outcomes by using hierarchical statistical models. PUBLIC HEALTH RELEVANCE: Sepsis is the 10th leading cause of death in the United States and is associated with extremely high in-hospital mortality, increased risks of death among survivors, and considerable use of healthcare resources. Evaluating measures of patient safety in patients with sepsis can highlight potential areas of deficiency in current care. Moreover, they can be used to enhance the quality and delivery of sepsis care.