DOI: 10.1097/01.ccm.0000458442.11317.33

,  

Issn Print: 0090-3493

Publication Date: 2014/12/01


Print

945: PREVALENCE AND PREDICTORS OF SEPTICEMIA IN PATIENTS WHO UNDERWENT MAJOR SURGICAL PROCEDURES IN USA.

Natalia Martinez-Schlurmann; Sankeerth Rampa; Romesh Nalliah; Veerasathpurush Allareddy; Karen Lidsky; Alexandre Rotta; Veerajalandhar Allareddy

+ Author Information

Author Information: Rainbow Babies and Childrens Hospital, Cleveland, OH

    loading  Checking for direct PDF access through Ovid

Excerpt

Learning Objectives: Complications associated with major surgical procedures (MSP) are associated with high mortality and surgical safety is now considered a significant public health concern. Our goal is to estimate the prevalence rates of septicemia in patients who had a MSP and to examine the impact of patient and hospital level factors on occurrence of septicemia.
Methods: We performed a retrospective analysis of the Nationwide Inpatient Sample, the largest inpatient discharge dataset in United States (2009–10). All patients with a MSP were selected. Occurrence of various types of septicemia was identified by using ICD-9-CM codes. Association between patient level (age, sex, race, co-morbid burden, insurance) and hospital level (teaching status, region) factors and occurrence of septicemia was examined by multivariable logistic regression. Effect of clustering of outcomes within hospitals was adjusted.
Results: A total of 22,932,947 hospitalizations involved a MSP. Characteristics included: mean age (48yrs), females (54%), whites (70%). Females were associated with lower odds of developing septicemia (OR=0.58, 95%CI=0.57–0.59, p<0.0001). Each one unit increase in co-morbid burden was associated with increased odds for septicemia (OR=1.56;1.54–1.58; p<0.0001). Blacks (OR=1.40; 1.34–1.46, p<0.0001), hispanics (OR=1.18;1.11–1.24, p<0.0001), asians/pacific islanders (OR=1.39;1.29–1.49, p<0.0001), and native Americans (OR=1.21;1.02–1.43, p=0.03) were associated with higher odds of developing septicemia when compared to whites. Those covered by private insurance had lower odds of developing septicemia when compared to the uninsured (p<0.0001). Patients cared for at teaching hospitals had higher odds of developing septicemia when compared to non-teaching hospitals (OR=1.20;1.13–1.28, p<0.0001).
Conclusions: In this large cohort of surgical patients, nearly 3% developed septicemia. There appears to be gender, racial and socio-economic factors associated with septicemia risk following a MSP. Higher septicemia rates at teaching hospital might be a reflection of increased case complexity inherent to these centers.
    loading  Loading Related Articles