• Anoop D Shah, Niall S MacCallum, Steve Harris, David A Brealey, Edward Palmer, James Hetherington, Sinan Shi, David Perez-Suarez, Ari Ercole, Peter J Watkinson, Andrew Jones, Simon Ashworth, Richard Beale, Stephen J Brett, and Mervyn Singer.
• University College London Hospitals NHS Foundation Trust, London, United Kingdom.
• Crit. Care Med. 2021 Nov 1; 49 (11): 188318941883-1894.

ObjectivesTo describe the epidemiology of sepsis in critical care by applying the Sepsis-3 criteria to electronic health records.DesignRetrospective cohort study using electronic health records.SettingTen ICUs from four U.K. National Health Service hospital trusts contributing to the National Institute for Health Research Critical Care Health Informatics Collaborative.PatientsA total of 28,456 critical care admissions (14,332 emergency medical, 4,585 emergency surgical, and 9,539 elective surgical).Measurements And Main ResultsTwenty-nine thousand three hundred forty-three episodes of clinical deterioration were identified with a rise in Sequential Organ Failure Assessment score of at least 2 points, of which 14,869 (50.7%) were associated with antibiotic escalation and thereby met the Sepsis-3 criteria for sepsis. A total of 4,100 episodes of sepsis (27.6%) were associated with vasopressor use and lactate greater than 2.0 mmol/L, and therefore met the Sepsis-3 criteria for septic shock. ICU mortality by source of sepsis was highest for ICU-acquired sepsis (23.7%; 95% CI, 21.9-25.6%), followed by hospital-acquired sepsis (18.6%; 95% CI, 17.5-19.9%), and community-acquired sepsis (12.9%; 95% CI, 12.1-13.6%) (p for comparison less than 0.0001).ConclusionsWe successfully operationalized the Sepsis-3 criteria to an electronic health record dataset to describe the characteristics of critical care patients with sepsis. This may facilitate sepsis research using electronic health record data at scale without relying on human coding.Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and Wolters Kluwer Health, Inc.

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