More Stringent Regulations For Hospitals Reduced Sepsis Deaths: Study

Fewer patients die from sepsis infections when hospitals in New York were required to follow more stringent detection and treatment standards, according to the findings of a new study that evaluated the impact of new protocols required in the state.

In 2013, New York instituted new regulations that mandate the use of evidence-based sepsis recognition and treatment at hospitals, requiring that facilities report their adherence and clinical outcomes.

According to findings published this week in the Journal of the American Medical Association (JAMA), University of Pittsburgh researchers compared hospital sepsis mortality rates at facilities in New York with hospitals that were not required to adhere to the protocols. They found a significant reduction in sepsis deaths at the New York facilities.

Researchers conducted a retrospective cohort study of adult patients at hospitals in New York, Florida, Maryland, Massachusetts, and New Jersey, using hospital discharge data from January 1, 2011 through September 30, 2015. The study included more than 1 million sepsis admissions to 509 hospitals over that time period.

According to the findings, before the regulations, New York hospitals had a 26.3% 30-day, in-hospital mortality rate for sepsis patients, compared to rates of 22% in the control states. New York’s mortality rate dropped to 22% over that time period, while the control states’ mortality rate dropped to 19.1%. However, it is unclear how well the protocols would fare outside of New York, researchers noted.

“Adjusting for patient and hospital characteristics as well as preregulation temporal trends and season, mortality after implementation of the regulations decreased significantly in New York State relative to the control states,” the researchers determined. “In New York State, mandated protocolized sepsis care was associated with a greater decrease in sepsis mortality compared with sepsis mortality in control states that did not implement sepsis regulations. Because baseline mortality rates differed between New York and comparison states, it is uncertain whether these findings are generalizable to other states.”

Sepsis is an infection of the bloodstream which can cause symptoms such as decreased blood pressure, fever, and increased heart rate. It is caused by bacteria, virus, and fungal infections and can lead to very severe conditions that result in death.

The infection affects roughly 1.7 million adults in the U.S. each year, with about 250,000 deaths linked to sepsis. It occurs in roughly 20-50 percent of hospitalizations that lead to death.