ArticleAmerican journal of respiratory and critical care medicine2014
Hospital case volume and outcomes among patients hospitalized with severe sepsis.
Article in American journal of respiratory and critical care medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
44 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The Volume-Outcome Relationship in Critical Care: A Systematic Review and Meta-analysis.Chest · 2015Pooled it
- Clinically recognized sepsis in older adults admitted to medical wards: patient characteristics and hospital outcomes from the REPOSI register.Internal and emergency medicine · 2026Article
- Impact of hospital sepsis case volume on mortality in sepsis patients: a meta-analysis.Frontiers in medicine · 2026Review
- Article
- Predictive value of laboratory indicators for in-hospital death in children with community-onset sepsis: a prospective observational study of 266 patients.BMJ paediatrics open · 2024Observational
- Inpatient Rehabilitation Facility Ownership Type Yields Mixed Performances on Quality Measures.Archives of physical medicine and rehabilitation · 2024Article
- Patient and Hospital Characteristics Associated With the Interhospital Transfer of Adult Patients With Sepsis.Critical care explorations · 2023Article
- The Relationship Between Hospital Capability and Mortality in Sepsis: Development of a Sepsis-Related Hospital Capability Index.Critical care medicine · 2023Article
- Are patient volume and care level in teaching hospitals variables affecting clinical outcomes in adult intensive care units?Einstein (Sao Paulo, Brazil) · 2023Article
- Updated estimates of sepsis hospitalizations at United States academic medical centers.Journal of the American College of Emergency Physicians open · 2022Article
- Identification of heptapeptides targeting a lethal bacterial strain in septic mice through an integrative approach.Signal transduction and targeted therapy · 2022Article
- Association of Annual Intensive Care Unit Sepsis Caseload With Hospital Mortality From Sepsis in the United Kingdom, 2010-2016.JAMA network open · 2021Article
- Hospital-level variation in the development of persistent critical illness.Intensive care medicine · 2020Article
- Double inter-hospital transfer in Sepsis patients presenting to the ED does not worsen mortality compared to single inter-hospital transfer.Journal of critical care · 2020Article
- Effects of a national quality improvement program on ICUs in China: a controlled pre-post cohort study in 586 hospitals.Critical care (London, England) · 2020Article
- Interhospital variation in mortality among patients with systemic lupus erythematosus and sepsis in the USA.Rheumatology (Oxford, England) · 2019Article
- National Performance on the Medicare SEP-1 Sepsis Quality Measure.Critical care medicine · 2019Article
- A Cost-Benefit Analysis of Automated Physiological Data Acquisition Systems Using Data-Driven Modeling.Journal of healthcare informatics research · 2019Article
- Hospital Mechanical Ventilation Volume and Patient Outcomes: Too Much of a Good Thing?Critical care medicine · 2019Article
- Hospital Volume of Immunosuppressed Patients with Sepsis and Sepsis Mortality.Annals of the American Thoracic Society · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
Abstract
rationaleProcesses of care are potential determinants of outcomes in patients with severe sepsis. Whether hospitals with more experience caring for patients with severe sepsis also have improved outcomes is unclear.
objectivesTo determine associations between hospital severe sepsis caseload and outcomes.
methodsWe analyzed data from U.S. academic hospitals provided through University HealthSystem Consortium. We used University HealthSystem Consortium's sepsis mortality model (c-statistic, 0.826) for risk adjustment. Validated International Classification of Disease, 9th Edition, Clinical Modification algorithms were used to identify hospital severe sepsis case volume. Associations between risk-adjusted severe sepsis case volume and mortality, length of stay, and costs were analyzed using spline regression and analysis of covariance. MEASUREMENTS AND MAIN
resultsWe identified 56,997 patients with severe sepsis admitted to 124 U.S. academic hospitals during 2011. Hospitals admitted 460 ± 216 patients with severe sepsis, with median length of stay 12.5 days (interquartile range, 11.1-14.2), median direct costs $26,304 (interquartile range, $21,900-$32,090), and average hospital mortality 25.6 ± 5.3%. Higher severe sepsis case volume was associated with lower unadjusted severe sepsis mortality (R2 = 0.10, P = 0.01) and risk-adjusted severe sepsis mortality (R2 = 0.21, P < 0.001). After further adjustment for geographic region, number of beds, and long-term acute care referrals, hospitals in the highest severe sepsis case volume quartile had an absolute 7% (95% confidence interval, 2.4-11.6%) lower hospital mortality than hospitals in the lowest quartile. We did not identify associations between case volume and resource use.
conclusionsAcademic hospitals with higher severe sepsis case volume have lower severe sepsis hospital mortality without higher costs.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.