A Closer Look at Sepsis-Associated Mortality

Rhee et al 1 report their findings from a retrospective review of hospital deaths and discharges to hospice discharges from 3 large academic medical centers and 3 affiliated community hospitals.Detailed medical record reviews were performed on 568 in-hospital deaths and discharges to hospice to determine if sepsis was present during the hospitalization and was a cause of death.For patients who died with or due to sepsis, investigators identified potential elements of suboptimal sepsis care, including delays in initiating antibiotic therapy, source control, or inadequate fluid resuscitation, and made an overall assessment of the "preventability" of a sepsis-associated death.The authors report that sepsis was present in 52.8% of hospitalizations leading to death or discharge to hospice.Patients with sepsis who died or were discharged to hospice frequently had severe underlying diseases such as cancer, dementia, or heart failure.In addition, in the study cohort, 40.4% of patients who died with sepsis had a hospice-qualifying condition on admission, illustrating +