Septic Shock Accounts for Large Share of In-Hospital Mortality for Infectious Disease and Respiratory Patients at Top Michigan Hospitals


In Sepsis

By: James Pitt  Aug. 06, 2018

Severe sepsis kills 15 to 30% of the million Americans affected per year, according to NIH estimates. Septic shock accounts for a large share of those deaths.

To pinpoint opportunities for better septic shock care and prevention, Dexur analysts examined in-hospital mortality rates in Medicare-eligible patients in Michigan.

Septic shock struck patients with a wide range of conditions. 17 of the 100 hospitals examined reported at least 11 deaths from septic shock. Index diagnoses included dysfunctions of nearly every organ, with renal and heart conditions particularly common.

In the Michigan sample, septic shock was a major contributor to overall mortality rates for five conditions.

  1. DRG 001 (heart transplant or implant of heart assist system with major complications)
  2. DRG 207 (respiratory system diagnosis with ventilator support 96+ hours)
  3. DRG 853 (infectious diseases with operating room procedure with major complications)
  4. DRG 870 (septic shock with major complications with mechanical ventilation 96+ hours)
  5. DRG 871 (septic shock with major complications with mechanical ventilation <96 hours)

Data from the four hospitals is presented below.

Diagnosis-Related Groups Where Septic Shock Most Increases Mortality, Michigan Hospitals

The role of septic shock in mortality rates for four of those conditions is unsurprising. Respiratory infections are common index diagnoses for sepsis patients nationwide; according to Gauer 2013, pneumonia is the most common presentation for sepsis.

An unexpected finding was that septic shock was involved in a high proportion of DRG 001 (heart transplant) in-hospital deaths. For example at Spectrum Health Butterworth (Grand Rapids, MI), septic shock was involved in 3% of in-hospital deaths for DRG 001. This accounts for one-fifth of the 15% mortality rate in DRG 001 patients at this hospital. This may indicate a opportunity for targeted care.

DEXUR PRO MEMBERS GET ACCESS TO:

  1. Total DRG Discharges
  2. Total Septic Shock Discharges at DRG
  3. % of Septic Shock Discharges at DRG
  4. Mortality Rates at DRG
  5. Mortality Due to Septic Shock
  6. Difference in Mortality Rates Total vs Without Septic Shock
  7. Mortality Rates with Septic Shock at DRG
  8. Difference in Mortality Rates with & without Septic Shock
  9. State Difference in Mortality Rates with & without Septic Shock
  10. National Difference in Mortality Rates with & without Septic Shock

For all DRGs reported in at least 11 patients at:

  1. Ascension St John Hospital (Detroit, MI)
  2. Beaumont Hospital - Troy (Troy, MI)
  3. Spectrum Health Butterworth Hospital (Grand Rapids, MI)
  4. Sparrow Hospital (Lansing, MI)


ABOUT THE AUTHOR

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James Pitt

James Pitt is a science writer with experience in medical devices and textbook publishing. His hobbies include reading, flintknapping, and squinting at RStudio. He received a bachelor's in Human Evolutionary Biology from Harvard.