Descriptors of Sepsis Using the Sepsis-3 Criteria: A Cohort Study in Critical Care Units Within the U.K. National Institute for Health Research Critical Care Health Informatics Collaborative.

To describe the epidemiology of sepsis in critical care by applying the Sepsis-3 criteria to electronic health records. Retrospective cohort study using electronic health records. Ten ICUs from four U.K. National Health Service hospital trusts contributing to the National Institute for Health Research Critical Care Health Informatics Collaborative. A total of 28,456 critical care admissions (14,332 emergency medical, 4,585 emergency surgical, and 9,539 elective surgical). Twenty-nine thousand three hundred forty-three episodes of clinical deterioration were identified with a rise in Sequential Organ Failure Assessment score of at least 2 points, of which 14,869 (50.7%) were associated with antibiotic escalation and thereby met the Sepsis-3 criteria for sepsis. A total of 4,100 episodes of sepsis (27.6%) were associated with vasopressor use and lactate greater than 2.0 mmol/L, and therefore met the Sepsis-3 criteria for septic shock. ICU mortality by source of sepsis was highest for ICU-acquired sepsis (23.7%; 95% CI, 21.9-25.6%), followed by hospital-acquired sepsis (18.6%; 95% CI, 17.5-19.9%), and community-acquired sepsis (12.9%; 95% CI, 12.1-13.6%) (p for comparison less than 0.0001). We successfully operationalized the Sepsis-3 criteria to an electronic health record dataset to describe the characteristics of critical care patients with sepsis. This may facilitate sepsis research using electronic health record data at scale without relying on human coding.

Informations de copyright

Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and Wolters Kluwer Health, Inc.

Déclaration de conflit d'intérêts

Drs. Shah’s, Watkinson’s, and Brett’s institutions received funding from the National Institute for Health Research (NIHR). Dr. Shah is supported by a postdoctoral fellowship funded by the Health Foundation's grant to the University of Cambridge for The Healthcare Improvement Studies Institute. Dr. Palmer received funding from the Medical Research Council and The London Clinic. Dr. Hetherington’s institution received funding from the United Kingdom Government; he received funding from Turing Institute and the Department of Health and Social Care; he received support for article research from Research Councils UK; he disclosed work for hire. Dr. Shi disclosed work for hire. Dr. Watkinson’s institution received funding from Wellcome and Sesnyne Health; he disclosed that he was the Chief Medical Officer for Sesnyne Health. Dr. Ashworth disclosed that he is an employee of Imperial College Healthcare National Health Service (NHS) Trust and the Clinical Director of Critical Care. Dr. Beale’s institution received funding from the Philips Medical Systems Medical Advisory Board; he disclosed that he is on the Steering Committee of the Surviving Sepsis Campaign. Dr. Singer’s institution received funding from Roche, Deltex, NewB, GE Healthcare, Pfizer, and Biomerieux. The views expressed are those of the authors and are not necessarily those of the NIHR, the NHS, or the United Kingdom Department of Health and Social Care. The remaining authors have disclosed that they do not have any potential conflicts of interest