C54-23 Sepsis Prevalence in Hospitalized Lung Transplant Patients: Implications of Different Sepsis Criteria and Discharge Diagnoses

Abstract Rationale Sepsis in lung transplant patients is associated with higher mortality when compared to the general population due to the chronic lifelong immunosuppression required to prevent organ rejection that weakens any biologic response to infection. Utilization of different sets of sepsis criteria may impact estimates of sepsis prevalence among lung transplant patients, which can complicate the rapid recognition and treatment needed to reduce sepsis-related mortality. Our objective was to report how frequently a population of hospitalized lung transplant patients prospectively identified as having sepsis met different sepsis criteria and how many of these received a sepsis billing code at time of discharge. Methods We reviewed lung transplant recipients hospitalized on regular nursing floors between February 2022 and July 2025. We included those patients for whom the Sepsis Emergency Response Team (SERT) had a strong clinical suspicion for sepsis. SERT is a clinician driven team that utilizes an early alert system housed in the electronic medical record to improve detection and treatment of inpatient sepsis. We further refined our cohort by including those who received new therapeutic antibiotics at the time of SERT identification. We determined how many patients met the following diagnostic criteria: Sepsis-2 or Sepsis-3 as defined by the Society of Critical Care Medicine, and those that received a sepsis discharge billing diagnosis. Results 52 individual patients were hospitalized for lung transplant management and had at least one episode concerning for sepsis. Mean age was 57.3 years and 19 (36.5%) were females. Inpatient mortality for the entire cohort was 3.8%. Of the 52 patients identified, 47 (90.3%) met Sepsis-2 criteria and 40 (76.9%) of patients met Sepsis-3 criteria at the time of SERT identification. 13 (25%) received a sepsis billing diagnosis at the time of discharge. Conclusion Our single center analysis of lung transplant recipients demonstrated a discrepancy in the number of patients that met different sepsis criteria and those that received sepsis discharge billing diagnoses. Our findings are consistent with previous data demonstrating decreased sepsis prevalence in hospitalized patients when using billing diagnoses rather than applying objective clinical criteria. Further research is needed to standardize the mechanisms by which sepsis prevalence is measured in lung transplant patients. This abstract is funded by: None