Characteristics of fully-automated sepsis incidence surveillance in a general hospital population
| All | No sepsis | Sepsis-3 clinical criteria | Community-onset* Sepsis-3 clinical criteria | Hospital-onset* Sepsis-3 clinical criteria | |
| Hospital admissions, No. | 82 653 | 74 054 | 8599 | 7493 | 1106 |
| Patients, No. | 54 884 | 51 343 | 7286 | 6472 | 1055 |
| Female sex, No. (%) | 27 928 (50.9) | 26 378 (51.4) | 3213 (43.9) | 2876 (44.2) | 430 (41.4) |
| Age, med (IQR) | 64.0 (47.0–75.0) | 63.0 (47.0–74.0) | 70.0 (59.0–80.0) | 70.0 (60.0–81.0) | 67.0 (54.0–76.0) |
| Length of stay, med (IQR) | 3.8 (2.0–7.6) | 3.3 (1.9–6.9) | 8.0 (4.2–15.7) | 7.0 (4.0–12.6) | 23.0 (14.7–36.7) |
| Charlson Comorbidity Index†, med (IQR) | 0 (0–2) | 0 (0–2) | 2 (0–3) | 2 (0–2) | 2 (0–3) |
| Comorbidities‡, No. (%) | |||||
| Chronic pulmonary disease | 2370 (4.3) | 2103 (4.1) | 692 (9.5) | 645 (10.0) | 76 (7.2) |
| Cancer | 14 036 (25.6) | 13 094 (25.5) | 2601 (35.7) | 2240 (34.6) | 514 (48.7) |
| Cerebral vascular disease | 4061 (7.4) | 3783 (7.4) | 670 (9.2) | 580 (9.0) | 123 (11.7) |
| Chronic heart failure | 2887 (5.3) | 2643 (5.1) | 792 (10.9) | 708 (10.9) | 113 (10.7) |
| Myocardial infarction | 2638 (4.8) | 2485 (4.8) | 403 (5.5) | 361 (5.6) | 49 (4.6) |
| Connective tissue disease | 1471 (2.7) | 1360 (2.6) | 287 (3.9) | 259 (4.0) | 42 (4.0) |
| Diabetes mellitus | 1681 (3.1) | 1541 (3.0) | 442 (6.1) | 394 (6.1) | 65 (6.2) |
| HIV infection | 54 (0.1) | 46 (0.1) | 18 (0.2) | 17 (0.3) | 2 (0.2) |
| Kidney disease | 2222 (4.0) | 1998 (3.9) | 644 (8.8) | 565 (8.7) | 111 (10.5) |
| Liver disease | 1281 (2.3) | 1173 (2.3) | 340 (4.7) | 294 (4.5) | 62 (5.9) |
| Prior surgery (30 days)§, No. (%) | 12 274 (14.9) | 10 091 (13.6) | 2186 (25.4) | 1458 (19.5) | 728 (65.8) |
| Suspected infection¶, No. (%) | 19 479 (23.6) | 10 880 (14.7) | 8599 (100.0) | 7493 (100.0) | 1106 (100.0) |
| Sepsis**, No. (%) | |||||
| Sepsis-3 clinical criteria | 8599 (10.4) | 0 (0.0) | 8599 (100.0) | 7493 (100.0) | 1106 (100.0) |
| ICD-10 coded | 2055 (2.5) | 907 (1.2) | 1148 (13.4) | 939 (12.5) | 209 (18.9) |
| Community-onset sepsis, No. (%) | 7493 (9.1) | 0 (0.0) | 7493 (87.1) | 7493 (100.0) | 0 (0.0) |
| Hospital-onset sepsis, No. (%) | 1106 (1.3) | 0 (0.0) | 1106 (12.9) | 0 (0.0) | 1106 (100.0) |
| ICU admission††, No. (%) | 4335 (5.2) | 3471 (4.7) | 864 (10.0) | 578 (7.7) | 286 (25.9) |
| ICU days, med (IQR) | 1.4 (0.9–4.1) | 1.2 (0.9–3.5) | 2.8 (1.1–6.3) | 2.1 (1.0–4.6) | 4.8 (2.0–11.4) |
| Bloodstream infection‡‡, No. (%) | 2659 (3.2) | 1104 (1.5) | 1555 (18.1) | 1279 (17.1) | 276 (25.0) |
| In-hospital mortality, No. (%) | 1953 (2.4) | 1216 (1.6) | 737 (8.6) | 596 (8.0) | 141 (12.7) |
*Hospital-onset defined as a sepsis episode 48 hours after admission or if the patient was readmitted with sepsis within 48 hours of discharge. All other sepsis episodes were defined as community-onset.
†Weighted Charlson comorbidity index.50 Total modified Charlson score: 0–24.
‡Comorbidity defined according to International Classification of Diseases (ICD)-10 codes registered within five years prior to hospitalisation.51
§Prior surgery was generated using procedure codes. For sepsis patients time zero was sepsis onset. For non-sepsis patients time zero was admission.
¶Defined as any culture taken and administration of two doses antimicrobials.
**Sepsis-3 defined as suspected infection combined with change in SOFA score of two points or more. ICD-10 codes including A02.1, A22.7, A26.7, A32.7, A39.2, A39.4, A40.x, A41.x, A42.7, A48.3, B37.7, M72.6, R57.2, R65.1 and R65.9.
††Intensive care unit admission any time during hospitalisation.
‡‡Bloodstream infection any time during hospitalisation (online supplement methods 2).
ICU, intensive care unit; med, median; SOFA, Sequential Organ Failure Assessment.