Hidden hospital mortality in patients with sepsis discharged from the intensive
            care unit

Aguiar-Ricardo, I; Mateus, Hélia; Gonçalves-Pereira, João

doi:10.5935/0103-507x.20190037

Cited by 8 publications

(6 citation statements)

References 26 publications

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“…Last, it did not consider following hospital discharge, particularly for ICU patients. Evidently, the higher mortality rate among sepsis patients after being discharged was a late-onset outcome of their ICU stays (Aguiar-Ricardo et al 2019;Biason et al 2019;Freitas et al 2019).…”

Section: Discussionmentioning

confidence: 99%

The burden and costs of sepsis and reimbursement of its treatment in a developing country: An observational study on focal infections in Indonesia

Purba

Mariana²,

Aliska³

et al. 2020

International Journal of Infectious Diseases

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This study aimed to determine the burden of sepsis with focal infections in the resourcelimited context of Indonesia and to propose national prices for sepsis reimbursement. Methods: A retrospective observational study was conducted from 2013-2016 on cost of surviving and non-surviving sepsis patients from a payer perspective using inpatient billing records in four hospitals. The national burden of sepsis was calculated and proposed national prices for reimbursement were developed. Results: Of the 14,076 sepsis patients, 5,876 (41.7%) survived and 8,200 (58.3%) died. The mean hospital costs incurred per surviving and deceased sepsis patient were US$1,011 (SE AE 23.4) and US$1,406 (SE AE 27.8), respectively. The national burden of sepsis in 100,000 patients was estimated to be US$130 million. Sepsis patients with multifocal infections and a single focal lower-respiratory tract infection (LRTI) were estimated as being the two with the highest economic burden (US$48 million and US$33 million, respectively, within 100,000 sepsis patients). Sepsis with cardiovascular infection was estimated to warrant the highest proposed national price for reimbursement (US$4,256). Conclusions: Multifocal infections and LRTIs are the major focal infections with the highest burden of sepsis. This study showed varying cost estimates for sepsis, necessitating a new reimbursement system with adjustment of the national prices taking the particular foci into account.

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Section: Discussionmentioning

confidence: 99%

The burden and costs of sepsis and reimbursement of its treatment in a developing country: An observational study on focal infections in Indonesia

Purba

Mariana²,

Aliska³

et al. 2020

International Journal of Infectious Diseases

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“…Mortality is documented in the literature in association with several factors, including increasing age 17,[23][24][25] . Costa 26 stated 117 critical patients with sepsis an increase in mortality in older age groups and in patients with a higher SOFA score at admission.…”

Section: Discussionmentioning

confidence: 99%

Phase Angle for Nutritional Risk Screening in Cardiac Critically Ill Patients

Tenório¹,

Rodrigues²,

Júnior³

et al. 2023

Rev Esp Nutr Hum Diet

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Introduction: The phase angle has been listed as a nutritional marker and its useful role in critically ill patients, but its role as a patient-to-patient tool has not yet been tested. This study sought to evaluate the phase angle as a proposal to determine nutritional risk in critically ill patients hospitalized in cardiac intensive care units. Methods: Transversal study, coupled to a prospective analysis variable (hospitalization outcome) and involving adult and elderly male and female patients in cardiac intensive care units. The nutritional risk was determined by using the NUTRICscore, the phase angle was obtained through bioelectrical impedance analysis and other data, through the clinical record. A significance level of p <0.05 was used for all statistical analysis. Results: 79 patients were included and resulted in homogeneous distribution among the sexes and an average age of 67.2 ± 13.7 years. Most of the sample had malnutrition according to the body mass index (BMI) (46.7%; CI: 36.0-57.8) and due to the adequacy of the arm circumference (40.8%; CI: 34.0-52.0). According to the NUTRIC score, 59.5% (CI: 48.5-69.3) had a high nutritional risk, and 68.4% (CI: 57.4-77.6) had a low phase angle (≤5.5 °). Correlation between the phase angle and age (p = 0.010) and BMI (p = 0.023) was verified. A good sensitivity (72%; CI: 55.6-81.9) and specificity (68%; CI: 42.5-77.5) of the low phase angle were obtained to detect nutritional risk by NUTRIC. Conclusions: The PhA had good results of sensitivity and specificity but should be used with caution to determine the nutritional risk in critically ill cardiac patients.

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“…On the contrary, younger patients may need more hospital resources [21]. These differences may be more striking in patients admitted to the ICU with a respiratory infection or sepsis [22][23][24].…”

Section: Table 4 Long-term Excess Mortality According To Age Groupmentioning

confidence: 99%

Critically ill patient mortality by age: long-term follow-up (CIMbA-LT)

Pereira

Oliveira

Vieira

et al. 2023

Ann. Intensive Care

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Background The past years have witnessed dramatic changes in the population admitted to the intensive care unit (ICU). Older and sicker patients are now commonly treated in this setting due to the newly available sophisticated life support. However, the short- and long-term benefit of this strategy is scarcely studied. Methods The Critically Ill patients’ mortality by age: Long-Term follow-up (CIMbA-LT) was a multicentric, nationwide, retrospective, observational study addressing short- and long-term prognosis of patients admitted to Portuguese multipurpose ICUs, during 4 years, according to their age and disease severity. Patients were followed for two years after ICU admission. The standardized hospital mortality ratio (SMR) was calculated according to the Simplified Acute Physiology Score (SAPS) II and the follow-up risk, for patients discharged alive from the hospital, according to official demographic national data for age and gender. Survival curves were plotted according to age group. Results We included 37.118 patients, including 15.8% over 80 years old. The mean SAPS II score was 42.8 ± 19.4. The ICU all-cause mortality was 16.1% and 76% of all patients survive until hospital discharge. The SAPS II score overestimated hospital mortality [SMR at hospital discharge 0.7; 95% confidence interval (CI) 0.63–0.76] but accurately predicted one-year all-cause mortality [1-year SMR 1.01; (95% CI 0.98–1.08)]. Survival curves showed a peak in mortality, during the first 30 days, followed by a much slower survival decline thereafter. Older patients had higher short- and long-term mortality and their hospital SMR was also slightly higher (0.76 vs. 0.69). Patients discharged alive from the hospital had a 1-year relative mortality risk of 6.3; [95% CI 5.8–6.7]. This increased risk was higher for younger patients [21.1; (95% CI 15.1–39.6) vs. 2.4; (95% CI 2.2–2.7) for older patients]. Conclusions Critically ill patients’ mortality peaked in the first 30 days after ICU admission. Older critically ill patients had higher all-cause mortality, including a higher hospital SMR. A long-term increased relative mortality risk was noted in patients discharged alive from the hospital, but this was more noticeable in younger patients.

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Hidden hospital mortality in patients with sepsis discharged from the intensive care unit

Cited by 8 publications

References 26 publications

The burden and costs of sepsis and reimbursement of its treatment in a developing country: An observational study on focal infections in Indonesia

The burden and costs of sepsis and reimbursement of its treatment in a developing country: An observational study on focal infections in Indonesia

Phase Angle for Nutritional Risk Screening in Cardiac Critically Ill Patients

Critically ill patient mortality by age: long-term follow-up (CIMbA-LT)

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