ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2025
Population Sepsis Incidence, Mortality, and Trends in Hong Kong Between 2009 and 2018 Using Clinical and Administrative Data.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed.
- Peritonitis and Mortality Risks of Gastric Acid Suppressants in Patients Undergoing Peritoneal Dialysis.Kidney international reports · 2026Article
- The Phoenix Criteria and Other Severity Scores in Identifying Pediatric Sepsis.JAMA network open · 2026Article
- Performance of sequential organ failure assessment 1 versus 2 for sepsis identification in patients with suspected infection: a multicenter retrospective cohort study.Critical care (London, England) · 2026Article
- Regional Adherence to Early Sepsis Management Bundle and Associated Mortality in Hong Kong Between 2009-2018.Open forum infectious diseases · 2026Article
- External validation of SOFA 2 score: a retrospective Chinese cohort study.Annals of intensive care · 2026Article
- Validation of a software application using electronic health records for automatic detection of community onset sepsis.Scientific reports · 2025Article
- Utilizing the National Early Warning Score 2 (NEWS2) to confirm the impact of emergency department management in sepsis patients: a cohort study from taiwan 1998-2020.International journal of emergency medicine · 2024Article
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Abstract
backgroundSepsis surveillance using electronic health record (EHR)-based data may provide more accurate epidemiologic estimates than administrative data, but experience with this approach to estimate population-level sepsis burden is lacking.
methodsThis was a retrospective cohort study including all adults admitted to publicly funded hospitals in Hong Kong between 2009 and 2018. Sepsis was defined as clinical evidence of presumed infection (clinical cultures and treatment with antibiotics) and concurrent acute organ dysfunction (≥2-point increase in baseline Sequential Organ Failure Assessment [SOFA] score). Trends in incidence, mortality, and case fatality risk (CFR) were modeled by exponential regression. Performance of the EHR-based definition was compared with 4 administrative definitions using 500 medical record reviews.
resultsAmong 13 540 945 hospital episodes during the study period, 484 541 (3.6%) had sepsis by EHR-based criteria with 22.4% CFR. In 2018, age- and sex-adjusted standardized sepsis incidence was 756 per 100 000 (relative change: +2.8%/y [95% CI: 2.0%-3.7%] between 2009 and 2018) and standardized sepsis mortality was 156 per 100 000 (relative change: +1.9%/y; 95% CI: .9%-2.8%). Despite decreasing CFR (relative change: -0.5%/y; 95% CI: -1.0%, -.1%), sepsis accounted for an increasing proportion of all deaths (relative change: +3.9%/y; 95% CI: 2.9%-4.8%). Medical record reviews demonstrated that the EHR-based definition more accurately identified sepsis than administrative definitions (area under the curve [AUC]: .91 vs .52-.55; P < .001).
conclusionsAn objective EHR-based surveillance definition demonstrated an increase in population-level standardized sepsis incidence and mortality in Hong Kong between 2009 and 2018 and was much more accurate than administrative definitions. These findings demonstrate the feasibility and advantages of an EHR-based approach for widescale sepsis surveillance.
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