ArticleAnnals of the American Thoracic Society2018
Hospital Volume of Immunosuppressed Patients with Sepsis and Sepsis Mortality.
Article in Annals of the American Thoracic Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed.
- In-hospital development of new-onset frailty and discharge outcomes among patients with sepsis: a Korean multicenter registry study.Journal of intensive care · 2026Article
- Impact of hospital sepsis case volume on mortality in sepsis patients: a meta-analysis.Frontiers in medicine · 2026Review
- Assessment of hemoglobin-to-red cell distribution width ratio to predict all-cause mortality in patients with sepsis: a retrospective cohort study from the MIMIC-IV database.Frontiers in medicine · 2026Article
- Enhancing SAPS-3 Predictive Accuracy with Initial, Peak, and Last Lactate Measurements in Septic Shock.Journal of clinical medicine · 2024Article
- Safety and Efficacy of Intramuscular Tixagevimab-Cilgavimab in Prevention of COVID-19 in Patients Who Are Immunocompromised.The Permanente journal · 2023Article
- Increase in Incidence Rates and Risk Factors for Multidrug Resistant Bacteria in Septic Children: A Nationwide Spanish Cohort Study (2013-2019).Antibiotics (Basel, Switzerland) · 2023Article
- Review
- Sepsis affects kidney graft function and one-year mortality of the recipients in contrast with systemic inflammatory response.Frontiers in medicine · 2022Article
- How Zinc-Binding Systems, Expressed by Human Pathogens, Acquire Zinc from the Colonized Host Environment: A Critical Review on Zincophores.Current medicinal chemistry · 2021Review
- A Multimodal Sepsis Quality-Improvement Initiative Including 24/7 Screening and a Dedicated Sepsis Response Team-Reduced Readmissions and Mortality.Critical care explorations · 2020Article
- Clinical spectrum and risk factors for hospital-acquired septicemia in a tertiary care centre of North-East India.Journal of family medicine and primary care · 2020Article
- [Treatment of infections in the critically ill under immunosuppression : What must be considered?]Zeitschrift fur Rheumatologie · 2019Review
- Update in Critical Care and Acute Respiratory Distress Syndrome 2018.American journal of respiratory and critical care medicine · 2019Article
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7 authors.
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Abstract
rationaleImmunosuppressive medical conditions are risk factors for mortality from severe infections. It is unknown whether hospital characteristics affect this risk.
objectivesTo determine whether the odds of death for an immunosuppressed patient with sepsis relative to a nonimmunosuppressed patient with sepsis varies according to the hospital's yearly case volume of immunosuppressed patients with sepsis.
methodsPatients with sepsis at hospitals in the Vizient database were characterized as immunosuppressed or not immunosuppressed on the basis of diagnosis codes and medication use. Hospitals were grouped into quartiles based on their average volumes of immunosuppressed patients with sepsis per year. Multilevel logistic regression with clustering of patients by hospital was used to determine whether the odds of in-hospital death from sepsis owing to a suppressed immune state varied by hospital quartile.
resultsThere were 350,183 patients with sepsis at 60 hospitals in the Vizient database from 2010 to 2012. Immunosuppressed patients with sepsis at the 15 hospitals in the lowest quartile (64 to 224 immunosuppressed patients with sepsis per year) had an increased odds of in-hospital death relative to nonimmunosuppressed patients with sepsis at these hospitals (adjusted odds ratio, 1.38; 95% confidence interval, 1.27-1.50; P < 0.001). The odds of in-hospital death for immunosuppressed patients with sepsis relative to nonimmunosuppressed patients with sepsis was similar for patients at hospitals in the second, third, and fourth quartiles (225 to 1,056 immunosuppressed patients with sepsis per year). The adjusted odds of death from sepsis owing to a suppressed immune state of 1.21 (95% confidence interval, 1.18-1.25; P < 0.001) for patients at these 45 hospitals was significantly less than for patients at the 15 hospitals in the lowest quartile (P = 0.004 for difference).
conclusionsThe risk of death from sepsis owing to a suppressed immune state was greatest at hospitals with the lowest volume of immunosuppressed patients with sepsis. Further study is needed to determine whether this finding is related to differences in patient characteristics or in care delivery at hospitals with different amounts of exposure to immunosuppressed patients.
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