An interesting article published in the May Edition of Critical Care Medicine (Gaieski et al., “Benchmarking the Incidence and Mortality of Severe Sepsis in the United States.” CCM May 2013. Volume 41. Number 5. DOI: 10.1097/CCM.0b013e31827c09f8) summarized a survey of sepsis reporting based upon ICD-9 codes established for sepsis, severe sepsis, and septic shock established in 2002-2003, and on the variability in reporting and rate of occurrence during the 6-year period from 2004-2009. Between 2002 and 2003, ICD-9 codes for sepsis, severe sepsis, and septic shock (995.91, 995.92, 785.52) were introduced.
Using ICD sepsis codes, the authors surveyed reports associated with these ICD-9 codes. What they found was that the average annual incidence of sepsis (ICD-9 Code 995.91) 231 cases of sepsis per 100,000 patients; 144 cases of severe sepsis (ICD-9 Code 995.92); and 95 cases of septic shock (ICD-9 Code 785.52) per 100,000 over this 6-year period.
Sepsis was identified as the 11th leading cause of death in US (Reference: CDC, 2009). Severe sepsis, defined as sepsis associated with new organ dysfunction, hypoperfusion or hypotension, has was estimated to cost U.S. healthcare system $24.3B in 2007.
Various studies considered:
Angus et al: 750,000 cases (300 / 100,000 population) and in-hospital mortality rate of 28.6% in 1995.
Martin et al.: 256,000 cases in 2000 (81 / 100,000).
Dombrovskiy et al.: 391,000 cases (134 / 100,000) with an in-hospital mortaility rate of 37.7% in 2003.
Wang et al.: 571,000 annual emergency department (ED) cases nationally between 2001 and 2003.
Gaieski et al. estimated that, for all sepsis codes, an annual increase in was observed and the rate of this increaase varied by ICD-9 code: 22.3% for sepsis, 25.3% for severe sepsis, 18.2% for septic shock.