Clinical Sepsis Data from EHRs Better Than Claims Data

This article appeared on HealthLeaders Media on September 14, 2017.

The findings challenge the use of claims data for sepsis surveillance.

New research led by investigators at Brigham and Women’s Hospital estimates the current United States burden of sepsis and trends using clinical data from the EHR systems of a large number of diverse hospitals.

The findings, published in JAMA, challenge the use of claims data for sepsis surveillance and suggest that clinical surveillance using EHR data provides more objective estimates of sepsis incidence and outcomes, the researchers said.

The research team developed a new strategy to track sepsis incidence and outcomes using electronic clinical data instead of insurance claims. Sepsis was identified if a patient had concurrent indicators of infection and organ dysfunction.

The researchers applied this definition to EHR data from nearly 3 million patients admitted to 409 U.S. hospitals in 2014; they found that sepsis was present in 6% of all hospitalizations and in more than one in three hospitalizations that ended in death.

These data were used to project the total burden of sepsis in hospitalized patients in 2014. They estimated that there were approximately 1.7 million sepsis cases nationwide in 2014, of whom 270,000 died.

In addition, the researchers assessed whether sepsis incidence and outcomes have been changing over time.

In contrast to prior claims-based estimates, they found no significant changes in adult sepsis incidence or in the combined outcome of hospital death or discharge to hospice between 2009 and 2014.