• Sarah Elfeky, Pegah Golabi, Munkhzul Otgonsuren, Svetolik Djurkovic, Mary E Schmidt, and Zobair M Younossi.
• Department of Medicine, Inova Fairfax Medical Campus, Falls Church, VA.
• J Crit Care. 2017 Jun 1; 39: 48-55.

PurposeTo assess recent epidemiologic characteristics, temporal trends, and predictors of death and discharge disposition in patients with sepsis.Material And MethodsThis is a cross-sectional retrospective cohort study using the US National Inpatient Sample (NIS) data from 2009 to 2012. The study population included adults (18years and older) with sepsis-related International Classification of Diseases, Ninth Revision, Clinical Modification codes at the time of discharge. Factors associated with in-hospital mortality and patient discharge disposition were derived from multivariate analyses using multinomial logistic models by SAS PROC LOGISTIC with GLOGIT link.ResultsOf 1 303 640 patients admitted, 15% died, 30% were discharged to home without home care, 34% were transferred to a skilled outpatient facility, and 4% were transferred to another short-term hospital. In-hospital mortality decreased from 16.5% to 13.8% (P<.001) across time. Length of stay also decreased from 6.7 to 5.9days (P<.001). Reductions in mortality and length of stay were seen despite an increase in the number of comorbidities (P<.001). Multivariate analysis revealed that the strongest predictors of in-hospital mortality were respiratory, cardiovascular, and hepatic failures, and neurologic events. The predictors of transfer to an outpatient facility were a major operative procedure, neurologic event, respiratory failure, and weight loss. Weight loss was also an independent predictor of in-hospital mortality.ConclusionCertain comorbidities and organ failures were associated with death and discharge to a skilled outpatient facility.Copyright © 2017 Elsevier Inc. All rights reserved.

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