Epidemiology of severe sepsis: 2008-2012

Introduction: Severe sepsis continues to be a significant burden on society. Methods: Using the International Classification of Diseases, Ninth Revision, Clinical Modification codes, we analyzed the Healthcare Cost and Utilization Project National Inpatient Sample in order to estimate epidemiologic trends of severe sepsis from the years 2008 to 2012. The 2010 US Census, which included 308745538 individuals, was used to calculate incidence per 100000 persons. Results: There were a total of 6067789 discharges for severe sepsis. The annual incidence increased from 346/100000 to 436/100000 persons (P < .05). Individuals with 3 or greater organ system failures increased from 31.6% to 35.5% (P < .05), and they accounted for 57.2% to 66.7% of the total number of deaths. Overall mortality decreased from 22.2% to 17.3% (P < .05). Length of stay decreased from 9 to 7 days (P < .05). Those discharged to home with and without home-health increased (23%-27%; P < .05), but those discharged to skilled nursing facilities remained the same (35%). Conclusions: The incidence of severe sepsis continues to increase, whereas mortality decreases. However, one third of patients (those with >= 3 organ system failures) account for two thirds of the total number of deaths. More people are discharged home, whereas stable numbers go to facilities. (C) 2015 Elsevier Inc. All rights reserved.