Descriptors of sepsis using the Sepsis-3 criteria: a cohort study in critical care units within the UK NIHR Critical Care Health Informatics Collaborative
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Author(s)
Type
Journal Article
Abstract
Objective: To describe the epidemiology of sepsis in critical care by applying the Sepsis-3 criteria to electronic health records. Design: Retrospective cohort study using electronic health records. Setting: Ten intensive care units (ICU) from four United Kingdom National Health Service hospital trusts contributing to the National Institute for Health Research Critical Care Health Informatics Collaborative (CC-HIC).Patients: 28,456 critical care admissions (14,332 emergency medical, 4,585 emergency surgical, and 9,539 elective surgical)Measurements and Main Results: 29,343 episodes of clinical deterioration were identified with a rise in Sequential Organ Failure Assessment (SOFA) 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. 4,100 episodes of sepsis (27.6%) were associated with vasopressor use and lactate > 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 <0.0001).Conclusions: 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.
Date Issued
2021-11
Date Acceptance
2021-04-29
Citation
Critical Care Medicine, 2021, 49 (11), pp.1883-1894
ISSN
0090-3493
Publisher
Lippincott, Williams & Wilkins
Start Page
1883
End Page
1894
Journal / Book Title
Critical Care Medicine
Volume
49
Issue
11
Copyright Statement
©2021 The Author(s).
Published by Wolters Kluwer Health,
Inc. on behalf of the Society of
Critical Care Medicine and Wolters
Kluwer Health, Inc. This is an open
access article distributed under
the Creative Commons Attribution
License 4.0 (CCBY), which permits
unrestricted use, distribution, and reproduction in any medium, provided
the original work is properly cited.
Published by Wolters Kluwer Health,
Inc. on behalf of the Society of
Critical Care Medicine and Wolters
Kluwer Health, Inc. This is an open
access article distributed under
the Creative Commons Attribution
License 4.0 (CCBY), which permits
unrestricted use, distribution, and reproduction in any medium, provided
the original work is properly cited.
License URL
Sponsor
Imperial College Healthcare NHS Trust- BRC Funding
Identifier
https://journals.lww.com/ccmjournal/Fulltext/2021/11000/Descriptors_of_Sepsis_Using_the_Sepsis_3_Criteria_.5.aspx
Grant Number
RDBRC 79560
Subjects
Emergency & Critical Care Medicine
1103 Clinical Sciences
1110 Nursing
1117 Public Health and Health Services
Publication Status
Published
Date Publish Online
2021-11