ArticleCritical care medicine2015
Temporal Changes in the Influence of Hospitals and Regional Healthcare Networks on Severe Sepsis Mortality.
Article in Critical care medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.
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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.
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Who cites it
31 citing papers in PubMed.
- Long-term bone metabolism outcomes in critically Ill patients with sepsis: a prospective series study.BMC infectious diseases · 2026Article
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- Epidemiological analysis of intra-abdominal infections in Italy from the Italian register of complicated intra-abdominal infections-the IRIS study: a prospective observational nationwide study.World journal of emergency surgery : WJES · 2025Observational
- Health-Related Quality of Life Among Patients Who Have Survived an Episode of Sepsis in the United States: A Systematic Review.Infectious diseases and therapy · 2025Review
- Three-year mortality of ICU survivors with sepsis, an infection or an inflammatory illness: an individually matched cohort study of ICU patients in the Netherlands from 2007 to 2019.Critical care (London, England) · 2024Article
- Management of intra-abdominal infections: recommendations by the Italian council for the optimization of antimicrobial use.World journal of emergency surgery : WJES · 2024Review
- Sepsis survivors readmitted within 30 days: outcomes of a single-center retrospective study.Critical care science · 2024Article
- Treatment Advances in Sepsis and Septic Shock: Modulating Pro- and Anti-Inflammatory Mechanisms.Journal of clinical medicine · 2023Review
- Acute kidney disease and long-term outcomes in critically ill acute kidney injury patients with sepsis: a cohort analysis.Clinical kidney journal · 2021Article
- Mortality related to drug-resistant organisms in surgical sepsis-3: an 8-year time trend study using sequential organ failure assessment scores.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2021Observational
- Article
- Hospital-level variation in the development of persistent critical illness.Intensive care medicine · 2020Article
- Surveillance Strategies for Tracking Sepsis Incidence and Outcomes.The Journal of infectious diseases · 2020Review
- Developing a template matching algorithm for benchmarking hospital performance in a diverse, integrated healthcare system.Medicine · 2020Observational
- Risk Adjustment for Sepsis Mortality to Facilitate Hospital Comparisons Using Centers for Disease Control and Prevention's Adult Sepsis Event Criteria and Routine Electronic Clinical Data.Critical care explorations · 2019Article
- Hospital contribution to variation in rates of vaginal birth after cesarean.Journal of perinatology : official journal of the California Perinatal Association · 2019Article
- Veterans Affairs patient database (VAPD 2014-2017): building nationwide granular data for clinical discovery.BMC medical research methodology · 2019Article
- Template matching for benchmarking hospital performance in the veterans affairs healthcare system.Medicine · 2019Observational
- Variation in Identifying Sepsis and Organ Dysfunction Using Administrative Versus Electronic Clinical Data and Impact on Hospital Outcome Comparisons.Critical care medicine · 2019Article
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Funding
Abstract
objectivesThere is systematic variation between hospitals in their care of severe sepsis, but little information on whether this variation impacts sepsis-related mortality, or how hospitals' and health-systems' impacts have changed over time. We examined whether hospital and regional organization of severe sepsis care is associated with meaningful differences in 30-day mortality in a large integrated health care system, and the extent to which those effects are stable over time.
designIn this retrospective cohort study, we used risk- and reliability-adjusted hierarchical logistic regression to estimate hospital- and region-level random effects after controlling for severity of illness using a rich mix of administrative and clinical laboratory data.
settingOne hundred fourteen U.S. Department of Veterans Affairs hospitals in 21 geographic regions. PATIENTS: Forty-three thousand seven hundred thirty-three patients with severe sepsis in 2012, compared to 33,095 such patients in 2008.
interventionsNone. MEASUREMENTS AND MAIN
resultsThe median hospital in the worst quintile of performers had a risk-adjusted 30-day mortality of 16.7% (95% CI, 13.5%, 20.5%) in 2012 compared with the best quintile, which had a risk-adjusted mortality of 12.8% (95% CI, 10.7%, 15.3%). Hospitals and regions explained a statistically and clinically significant proportion of the variation in patient outcomes. Thirty-day mortality after severe sepsis declined from 18.3% in 2008 to 14.7% in 2012 despite very similar severity of illness between years. The proportion of the variance in sepsis-related mortality explained by hospitals and regions was stable between 2008 and 2012.
conclusionsIn this large integrated healthcare system, there is clinically significant variation in sepsis-related mortality associated with hospitals and regions. The proportion of variance explained by hospitals and regions has been stable over time, although sepsis-related mortality has declined.
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