Indicator Metadata
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Name |
In-Hospital Sepsis |
Short/Other Names |
Not applicable |
Description |
The risk-adjusted rate of sepsis that is identified after admission. For further details, please see the General Methodology Notes (PDF). |
Interpretation |
A lower rate for this indicator is desirable. |
HSP Framework Dimension |
Health System Outputs: Safe |
Areas of Need |
Getting Better |
Geographic Coverage |
All provinces/territories |
Reporting Level/Disaggregation |
National, Province/Territory, Region, Facility |
Indicator Results |
Name |
In-Hospital Sepsis |
Short/Other Names |
Not applicable |
Description |
The risk-adjusted rate of sepsis that is identified after admission. For further details, please see the General Methodology Notes (PDF). |
Calculation: Description |
This indicator measures the rate of in-hospital sepsis per 1,000 discharges. 2 logistic regression models were built separately for children (younger than 18 years) and adults (18 years and older) to calculate the risk-adjusted results. Risk-adjusted rate = Observed cases ÷ Expected cases × Canadian average Unit of analysis: Single admission |
Calculation: Geographic Assignment |
Place of service |
Calculation: Type of Measurement |
Rate - Rate—per 1,000 |
Calculation: Adjustment Applied |
The following covariates are used in risk adjustment: |
Calculation: Method of Adjustment |
Logistic regression |
Denominator |
Description:
Exclusions:
|
Numerator |
Description: Inclusions: Sepsis events are identified as follows: Non-Quebec abstracts:
As an exception, sepsis is not considered as a pre-admit condition when the above codes identified as type (M), (W), (X) or (Y) also appear as type (2) or within a post-admit sepsis coding scenario:
|
Rationale |
Sepsis is a clinical syndrome that occurs as a complication of infections. It is defined as a systemic inflammatory response due to infection. Sepsis is a leading cause of mortality and is linked to increased hospital resource utilization and prolonged stays in intensive care units. Appropriate preventive and therapeutic measures during a hospital stay can reduce the rate of infections and/or progression of infection to sepsis. The indicator addresses the extent to which acute care hospitals are effective in preventing the development of sepsis. It will help hospitals improve patient safety and learn from their peers regarding best practice methods for appropriate treatment of infections and prevention of sepsis. |
Interpretation |
A lower rate for this indicator is desirable. |
HSP Framework Dimension |
Health System Outputs: Safe |
Areas of Need |
Getting Better |
Targets/Benchmarks |
Not applicable |
References |
Agency for Healthcare Research and Quality. Technical Specifications: Patient Safety Indicators Appendices Version 4.5. http://www.qualityindicators.ahrq.gov/Downloads/Modules/PSI/V45/TechSpecs/PSI%20Appendices.pdf Angus DC, Linde-Zwirble WT, Lidicker J, et al. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med. 2001;29:1303-1310. Canadian Institute for Health Information. In Focus: A National Look at Sepsis. https://secure.cihi.ca/free_products/HSMR_Sepsis2009_e.pdf Canadian Institute for Health Information. Canadian Coding Standards for Version 2012 ICD-10-CA and CCI. Ottawa, ON: CIHI; 2012. Drosler S. Organisation for Economic Co-operation and Development: Health Care Quality Indicators Project, Patient Safety Indicators—Report 2009. http://www.oecd.org/els/health-systems/44193189.pdf Levy MM, Dellinger RP, Townsend SR, et al. The Surviving Sepsis Campaign: Results of an international guideline-based performance improvement program targeting severe sepsis. Crit Care Med 2010;38:367-374. Levy MM, Fink MP, Marshall JC et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med 2003;31:1250-1256. Martin CM, Priestap F, Fisher H et al. A prospective, observational registry of patients with severe sepsis: the Canadian Sepsis Treatment and Response Registry. Crit Care Med 2009;37:81-88. Quan H, Li B, Couris CM, et al. Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. Am J Epidemiol 2011;173:676-82. |
Data Sources |
DAD, HMDB |
Available Data Years |
Type of Year: |
Geographic Coverage |
All provinces/territories |
Reporting Level/Disaggregation |
National, Province/Territory, Region, Facility |
Update Frequency |
Every year |
Indicator Results |
Web Tool: |
Updates |
Not applicable |
Caveats and Limitations |
In-hospital sepsis events can be due to either community- or hospital-acquired infections. Therefore, the in-hospital sepsis indicator does not necessarily capture hospital-acquired infections only. In addition, despite the implementation of national coding standards, there may be variations in charting and coding practices across the country that could affect the results. |
Trending Issues |
Not applicable |
Comments |
Indicator results are also available in
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