ReviewClinical infectious diseases : an official publication of the Infectious Diseases Society of America2016
Impact of Policies on the Rise in Sepsis Incidence, 2000-2010.
Review in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2016. 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.
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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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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.
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Who cites it
44 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Frequency and mortality of septic shock in Europe and North America: a systematic review and meta-analysis.Critical care (London, England) · 2019Pooled it
- Outcomes following surgical management of urinary stone disease in older patients.The Canadian journal of urology · 2026Article
- Think sepsis, write sepsis, code sepsis - patient characteristics associated with sepsis (under-)coding in administrative health data.Infection · 2026Article
- Does DRG-based payment lead to unintended effects on care quality? A case under global budget with price adjustment in China.BMC health services research · 2025Article
- Protective role of triiodothyronine in sepsis‑induced cardiomyopathy through phospholamban downregulation.International journal of molecular medicine · 2025Article
- SepsisJournal of medical microbiology · 2025Review
- DRGKB: a knowledgebase of worldwide diagnosis-related groups' practices for comparison, evaluation and knowledge-guided application.Database : the journal of biological databases and curation · 2024Article
- Improving Sepsis Outcomes in the Era of Pay-for-Performance and Electronic Quality Measures: A Joint IDSA/ACEP/PIDS/SHEA/SHM/SIDP Position Paper.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- The bone marrow endothelial progenitor cell response to septic infection.Frontiers in immunology · 2024Article
- Identification and experimental validation of diagnostic and prognostic genes CX3CR1, PID1 and PTGDS in sepsis and ARDS using bulk and single-cell transcriptomic analysis and machine learning.Frontiers in immunology · 2024Article
- Article
- Observational
- Non-linear relationship between baseline mean arterial pressure and 30-day mortality in patients with sepsis: a retrospective cohort study based on the MIMIC-III database.Annals of translational medicine · 2022Article
- Proportions and trends of adult hospitalizations with Diabetes, United States, 2000-2018.Diabetes research and clinical practice · 2022Article
- Antibiotic Use and Bacterial Infection among Inpatients in the First Wave of COVID-19: a Retrospective Cohort Study of 64,691 Patients.Antimicrobial agents and chemotherapy · 2021Article
- Lipid and Lipoprotein Dysregulation in Sepsis: Clinical and Mechanistic Insights into Chronic Critical Illness.Journal of clinical medicine · 2021Review
- Infectious Diseases Society of America Position Paper: Recommended Revisions to the National Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) Sepsis Quality Measure.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Evaluating inpatient adverse outcomes under California's Delivery System Reform Incentive Payment Program.Health services research · 2021Article
- Article
- Sepsis and septic shock in France: incidences, outcomes and costs of care.Annals of intensive care · 2020Article
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Authors and funding
7 authors.
Funding
Abstract
backgroundSepsis hospitalizations have increased dramatically in the last decade. It is unclear whether this represents an actual rise in sepsis illness or improved capture by coding. We evaluated the impact of Centers of Medicare and Medicaid Services (CMS) guidance after newly introduced sepsis codes and medical severity diagnosis-related group (MS-DRG) systems on sepsis trends.
methodsIn this retrospective cohort study of California hospitalizations from January 2000 to December 2010, sepsis was identified by International Classification of Diseases, Ninth Revision (ICD-9) coding (Dombrovskiy method). Sepsis-associated mortality rates were calculated. Logistic regression models evaluated variables associated with sepsis and mortality. Segmented regression time series analysis assessed changes in sepsis frequency for (1) baseline (January 2000 to September 2003); (2) post-CMS guidelines on sepsis coding (October 2003 to September 2007); and (3) after the introduction of MS-DRG (October 2007 to December 2010).
resultsAnnual hospitalizations with sepsis diagnoses tripled within a decade, from 21.1 to 59.9 cases per 1000 admissions, with a 2.8- and 2.0-fold increase in severe and nonsevere sepsis, respectively, whereas annual admissions remained unchanged and sepsis-associated mortality decreased. Greatest increases were seen for severe sepsis present on admission (3.8-fold increase). Increases in sepsis were temporally correlated with CMS coding guidance and MS-DRG introduction after adjustment for comorbidity and other factors.
conclusionsSepsis rate increases were associated with introduction of CMS-issued guidance for new sepsis ICD-9 coding and MS-DRGs. Coding artifact ("up-capture" of less severely ill septic patients) may be contributing to the apparent rise in sepsis incidence and decline in mortality. Epidemiologic trends based on administrative data should account for policy-related effects.
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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.