In-Hospital Sepsis Mortality Rates Comparing Tertiary and Non-Tertiary Hospitals in Washington State

Publication date: Available online 6 March 2018
Source:The Journal of Emergency Medicine
Author(s): Gail G. Salvatierra, Bernice G. Gulek, Baran Erdik, Deborah Bennett, Kenn B. Daratha
BackgroundMore than a million people a year in the United States experience sepsis or sepsis-related complications, and sepsis remains the leading cause of in-hospital deaths. Unlike many other leading causes of in-hospital mortality, sepsis detection and treatment are not dependent on the presence of any technology or services that differ between tertiary and non-tertiary hospitals.ObjectiveTo compare sepsis mortality rates between tertiary and non-tertiary hospitals in Washington State.MethodsA retrospective longitudinal, observational cohort study of 73 Washington State hospitals for 2010–2015 using data from a standardized state database of hospital abstracts. Abstract records on adult patients (n = 86,378) admitted through the emergency department (ED) from 2010 through 2015 in all tertiary (n = 7) and non-tertiary (n = 66) hospitals in Washington State.ResultsThe overall mortality rate for all hospitals was 6.5%. In the fully adjusted model, the odds ratio for in-hospital death was higher in non-tertiary hospitals compared with tertiary hospitals (odds ratio 1.25; 95% confidence interval 1.17–1.35; p < 0.001).ConclusionsWe observed higher sepsis mortality rates in non-tertiary hospitals, compared with tertiary hospitals. Because most patients who are treated for sepsis are treated outside of tertiary hospitals, and the number of patients treated for sepsis in non-tertiary hospitals seems to be rising, a better understanding of the cause or causes for this differential is crucial.



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