Risk for poor outcomes may be higher in previously healthy patients hospitalized for sepsis
While 97.4% of patients hospitalized for community-onset sepsis had preexisting comorbid conditions, those who were healthy before admission had higher short-term mortality rates in a recent study.
Previously healthy patients account for fewer hospitalizations for community-onset sepsis than patients with comorbid conditions but may have worse outcomes, a recent study found.
To compare outcomes after hospitalization for community-onset sepsis in previously healthy patients and those with comorbid conditions, researchers performed a retrospective study using data from 373 U.S. hospitals from 2009-2015. Community-onset sepsis was determined by the CDC's Adult Sepsis Event criteria, and ICD-9-CM codes were used to identify comorbid conditions. The study measured the associations between the presence or absence of comorbidities and short-term mortality (in-hospital death or discharge to hospice), with adjustment for illness severity at admission. The results were published Jan. 20 by CHEST.
Among 6,715,286 hospitalized patients, 5.0% had community-onset sepsis. Of these, most (97.4%) had at least one comorbid condition and 2.6% were previously healthy. Those who were previously healthy were younger (mean age, 58.0 vs. 67.0 years), less likely to require ICU care on admission (37.9% vs. 50.5%), and more likely to be discharged home (57.9% vs. 45.6%) than those with comorbid conditions; however, previously healthy patients had higher short-term mortality rates (22.8% vs. 20.8%) (P<0.001 for all comparisons). Previously healthy status remained associated with higher short-term mortality rates after risk adjustment (adjusted odds ratio, 1.99; 95% CI, 1.87 to 2.13).
The authors noted that their study was conducted before the COVID-19 pandemic and that their results may have been affected by selection bias, among other limitations. They concluded that while most patients hospitalized with community-onset sepsis have preexisting comorbid conditions, those who are healthy before admission for this condition may be more likely to die. “These findings underscore the importance of preventative care and health maintenance to prevent sepsis hospitalizations, provide context for high-profile reports about sepsis deaths in previously healthy people, and underscore the importance of early sepsis recognition and treatment for all patients,” the authors wrote.