CDC: Sepsis Cost $14.6B in 2008

The number of septicemia and sepsis hospitalizations more than doubled between 2000 and 2008, resulting in much longer, costlier hospitals stays, and more problematic and often fatal outcomes for patients with the bloodstream infections, according to a report from the Centers for Disease Control and Prevention.

"Reasons for these increases may include an aging population with more chronic illnesses; greater use of invasive procedures, immunosuppressive drugs, chemotherapy, and transplantation; and increasing microbial resistance to antibiotics. Increased coding of these conditions due to greater clinical awareness of septicemia or sepsis may also have occurred during the period studied," said the study, Inpatient Care for Septicemia or Sepsis: A Challenge for Patients and Hospitals, a data brief compiled by CDC's National Center for Health Statistics.

Hospitalizations for septicemia or sepsis as a principal diagnosis grew from 326,000 in 2000 to 727,000 in 2008. In the same time span, the rate of the hospitalizations also more than doubled from 11.6 per 10,000 population to 24 per 10,000, and cost an estimated $14.6 billion to treat in 2008, the report said.

The report, like studies conducted by the Dartmouth Atlas and others, shows that there is little correlation between how much a hospital spends and the quality of patient outcomes.

"Even with this expenditure, the death rate was high. Patients who do survive severe cases are more likely to have negative long-term effects on health and on cognitive and physical functioning," the report said.

Last year, University of Michigan researchers found that older hospitalized patients who survive sepsis develop lasting, moderate to severe cognitive impairment and functional disability at 3.3 times the rate of patients hospitalized for other reasons. Those consequences were labeled a "public health disaster" in a JAMA commentary.

While accounting for only 2% of hospitalizations in 2008, sepsis and septicemia made up 17% of in-hospital deaths. And patients who survived hospitalization with sepsis or septicemia were twice as likely to be transferred to another short-term care facility, and three-times as likely to be transferred to a long-term care facility, the CDC study found. 

The bloodstream infections overwhelmingly affected the elderly, most of whom are Medicare recipients. About two-thirds of patients hospitalized with sepsis or septicemia were age 65 or over, and the hospitalization rate for sepsis and septicemia patients aged 85 or older (271.2 per 10,000 population) was 30 higher than the rate for those under age 65, (9.5 per 10,000 population), and more than four times higher than the rate of hospitalization (65.7 per 10,000) for those ages 65-74, the report said.

The hospitalization rates include: patients hospitalized for septicemia or sepsis; patients hospitalized for another diagnosis but who had septicemia or sepsis at the time they were admitted; and patients who acquired septicemia or sepsis during their hospital stay.