Risk factors for sepsis morbidity in a rural hospital population: A case-control study

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HighlightsSepsis risk was associated with indwelling medical device use in a rural hospital.Risk factors for sepsis morbidity also included coronary heart disease.Government-issued health insurance had a borderline significance with sepsis risk.Sepsis was most frequently secondary to urinary tract infections and pneumonia.Background:The aim of the study was to identify risk factors for sepsis morbidity in a rural hospital population.Methods:We used a case-control study design. Patients included adult admissions to a rural health system between January 1, 2012, and December 31, 2015. Case selection was by electronic medical record search for codes of the ICD-9-CM. Cases were validated against Quick Sequential Organ Failure Assessment criteria. Multiple logistic regression modeling was performed to determine which predefined variables were significantly associated with sepsis diagnosis.Results:A total of 220 patients were studied (110 cases and 110 controls). Cases had an in-hospital mortality of 20% compared with 0% of the controls. Indwelling medical device use during hospitalization (adjusted odds ratio [OR], 3.02; 95% confidence interval [CI], 1.44-6.30; P = .003), coronary heart disease (adjusted OR, 2.59; 95% CI, 1.13-5.97; P = .03), and type of health insurance (adjusted OR, 2.36; 95% CI, 1.13-4.93; P = .02) were independently associated with sepsis diagnosis after adjusting for potential confounders.Conclusions:This study underscores the need for implementation and maintenance of infection control measures during management of patients with indwelling medical devices at a rural hospital.

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