How sepsis impacts outpatient visits

September 17, 2020

Sepsis is an unexpected event that can have aftereffects. A research letter looks at how sepsis can impact outpatient visits for the effected child.

Sepsis can be a serious problem with over 70,000 children hospitalized with severe sepsis every year in the United States, which results in more than $7.3 billion in health care costs. A research letter in JAMA Network Open looked at how outpatient health visits changed among children who had survived sepsis.1

Researchers ran a cohort study, which followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline. They looked at pediatric severe sepsis hospitalizations that were in Optum’s deidentified Clinformatics Data Mart database. Sepsis cases were found either through an explicit diagnosis cord or concurrent codes. The comparison of the number of the outpatient visits before and the year after a severe sepsis hospitalization used a t test and the type of visit was compared using a χ2 test. The children included in the analysis had to be consecutively enrolled in insurance for at least 3 months before their hospitalization for sepsis.

From the 167,497 hospitalizations found, 952 were for severe sepsis. Among those 952 children hospitalized for sepsis, 855 survived to discharge. The cohort of sepsis survivors had a median age of 12 years who had a median length of stay in the hospital of 9 days. The researchers found that the outpatient visits increased from a median of 5 visits in the year before hospitalization to 8 visits in the year after hospitalization as well as from 2 visits in the 90 days before the hospitalization to 3 visits in the 90 days following hospitalization. Among the 855 patients, 478 had more visits in the 90 days following hospitalization versus before hospitalization and overall 514 had more visits after hospitalization than before sepsis.

The investigators concluded that the median number of outpatients visit increased by 60% in the year following hospitalization when compared with each patient’s baseline. However, the increase in outpatient visits did not occur in every patient, which they said highlights how different the postsepsis life can be.

Reference

1. Carlton E, Kohne J, Hensley M, Prescott H. Comparison of outpatient health care use before and after pediatric severe sepsis. JAMA Netw Open. 2020;3(9):e2015214. doi:10.1001/jamanetworkopen.2020.15214