The patient-related costs of care for sepsis patients in a United Kingdom adult general intensive care unit

OBJECTIVE: To determine the patient-related costs of care for critically ill patients with severe sepsis or early septic shock. DESIGN: Retrospective, longitudinal, observational study during a 10-month period. SETTING: Adult general intensive care unit (ICU) in a university hospital located in the United Kingdom. PATIENTS: The study population consisted of 213 patients admitted consecutively to the ICU during a 10-month period. Thirty-six patients were identified using standard definitions as having developed sepsis and analyzed by group (according to the day on which sepsis was diagnosed): Group 1 patients were septic at admission to ICU (n = 16) ; group 2 patients were septic on their second day in the ICU (n = 10) ; and group 3 patients developed sepsis after their second day in the ICU (n = 10). One hundred and seventy-seven ICU patients without sepsis were used as the comparative group (group 4). INTERVENTIONS: None. MAIN RESULTS: Patient-related costs of care, length of ICU stay, and ICU and hospital mortality rates were compiled. The median daily costs of care for patients in groups 1, 2, and 3 were 930. 74 (interquartile range 851. 59-1, 263. 96) ; 814. 47 (650. 89-1, 123. 06), and 1, 079. 39 (705. 02-1, 295. 96), respectively; these were significantly more than the group 4 patient's daily cost of 750. 38 (644. 10-908. 55) (p <. 01). The median total cost of treating the group 4 patients was 1, 666. 87 (979. 71-2, 772. 03), significantly less than for the patients with sepsis (p <. 01). The difference in total costs of care between the sepsis groups was also significant (p <. 05), with a group 1 patient costing 3, 801. 55 (1, 865. 28-11, 676. 08), a group 2 patient costing 13, 089. 17 (5, 792. 94-22, 235. 18), and a group 3 patient costing 17, 962. 78 (13, 030. 83-28, 546. 73). Patients in groups 1, 2, and 3 stayed in the ICU for 3. 3 days (1. 3-11. 3), 16. 5 days (8. 9-22), and 16. 1 days (10. 9-9), respectively. Significant differences were found among the three groups (p < 0. 05), as well as between the patients with sepsis and those without (p < 0. 001), whose median length of stay was 1. 9 days (0. 9-3. 6). The ICU mortality rates were 50% each for groups 1 and 2, 60% for group 3, and 20% for group 4. Only one patient with sepsis and 16 patients without sepsis died in the hospital ward, producing overall mortality rates of 56% for group 1 and 29% for group 4. CONCLUSIONS: Patients with severe sepsis or early septic shock had a high mortality rate, spent prolonged periods of time in the ICU, and were significantly more expensive to treat than nonsepsis ICU patients.