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Population sepsis incidence, mortality, and trends in Hong Kong between 2009-2018 using clinical and administrative data.
Ling, Lowell; Zhang, Jack Zhenhe; Chang, Lok Ching; Chiu, Lok Ching Sandra; Ho, Samantha; Ng, Pauline Yeung; Dharmangadan, Manimala; Lau, Chi Ho; Ling, Steven; Man, Man Yee; Fong, Ka Man; Liong, Ting; Yeung, Alwin Wai Tak; Au, Gary Ka Fai; Chan, Jacky Ka Hing; Tang, Michele; Liu, Ying Zhi; Wu, William Ka Kei; Wong, Wai Tat; Wu, Peng; Cowling, Benjamin J; Lee, Anna; Rhee, Chanu.
  • Ling L; Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
  • Zhang JZ; Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
  • Chang LC; Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
  • Chiu LCS; Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
  • Ho S; Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
  • Ng PY; Critical Care Medicine Unit, The University of Hong Kong, Hong Kong SAR, China.
  • Dharmangadan M; Department of Adult Intensive Care, Queen Mary Hospital, Hong Kong SAR, China.
  • Lau CH; Department of Intensive Care, Princess Margaret Hospital, Hong Kong SAR, China.
  • Ling S; Department of Intensive Care, North District Hospital, Hong Kong SAR, China.
  • Man MY; Department of Intensive Care, Tuen Mun Hospital, Hong Kong SAR, China.
  • Fong KM; Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China.
  • Liong T; Department of Intensive Care, Queen Elizabeth Hospital, Hong Kong SAR, China.
  • Yeung AWT; Department of Intensive Care, United Christian Hospital, Hong Kong SAR, China.
  • Au GKF; Department of Medicine & Geriatrics, Ruttonjee and Tang Shiu Kin Hospitals, Hong Kong SAR, China.
  • Chan JKH; Department of Intensive Care, Kwong Wah Hospital, Hong Kong SAR, China.
  • Tang M; Department of Medicine, Tseung Kwan O Hospital, Hong Kong SAR, China.
  • Liu YZ; Department of Medicine and Geriatrics, Caritas Medical Centre, Hong Kong SAR, China.
  • Wu WKK; Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
  • Wong WT; Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
  • Wu P; State Key Laboratory of Digestive Diseases, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China.
  • Cowling BJ; Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, China.
  • Lee A; CUHK Shenzhen Research Institute, Shenzhen, China.
  • Rhee C; Peter Hung Pain Research Institute, The Chinese University of Hong Kong, Hong Kong SAR, China.
Clin Infect Dis ; 2023 Aug 19.
Article en En | MEDLINE | ID: mdl-37596856
ABSTRACT

BACKGROUND:

Sepsis surveillance using electronic health record (EHR)-based data may provide more accurate epidemiologic estimates than administrative data, but experience with this approach to estimate population-level sepsis burden is lacking.

METHODS:

This was a retrospective cohort study including all adults admitted to publicly-funded hospitals in Hong Kong between 2009-2018. Sepsis was defined as clinical evidence of presumed infection (clinical cultures and treatment with antibiotics) and concurrent acute organ dysfunction (≥2 point increase in baseline SOFA score). Trends in incidence, mortality, and case fatality risk (CFR) were modelled by exponential regression. Performance of the EHR-based definition was compared with 4 administrative definitions using 500 medical record reviews.

RESULTS:

Among 13,550,168 hospital episodes during the study period, 485,057 (3.6%) had sepsis by EHR-based criteria with 21.5% CFR. In 2018, age- and sex-adjusted standardized sepsis incidence was 759 per 100,000 (relative +2.9%/year [95%CI 2.0, 3.8%] between 2009-2018) and standardized sepsis mortality was 156 per 100,000 (relative +1.9%/year [95%CI 0.9,2.9%]). Despite decreasing CFR (relative -0.5%/year [95%CI -1.0, -0.1%]), sepsis accounted for an increasing proportion of all deaths (relative +3.9%/year [95%CI 2.9, 4.9%]). Medical record reviews demonstrated that the EHR-based definition more accurately identified sepsis than administrative definitions (AUC 0.91 vs 0.52-0.55, p < 0.001).

CONCLUSIONS:

An objective EHR-based surveillance definition demonstrated an increase in population-level standardized sepsis incidence and mortality in Hong Kong between 2009-2018 and was much more accurate than administrative definitions. These findings demonstrate the feasibility and advantages of an EHR-based approach for widescale sepsis surveillance.
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Texto completo: 1 Banco de datos: MEDLINE Tipo de estudio: Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Año: 2023 Tipo del documento: Article

Texto completo: 1 Banco de datos: MEDLINE Tipo de estudio: Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Año: 2023 Tipo del documento: Article