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Crit Care Med. Author manuscript; available in PMC 2017 July 01. Published in final edited form as: Crit Care Med. 2016 July ; 44(7): 1380–1387. doi:10.1097/CCM.0000000000001665.
Defining Sepsis Mortality Clusters in the United States Justin Xavier Moore, M.P.H1,2, John P. Donnelly, M.S.P.H1,2, Russell Griffin, Ph.D2, Dr. George Howard, P.H.3, Monika M. Safford, M.D.4, and Henry E Wang, M.D., M.S.1 1Department
of Emergency Medicine, University of Alabama School of Medicine, Birmingham,
Alabama
Author Manuscript
2Department
of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama
3Department
of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama
4Department
of Medicine, University of Alabama School of Medicine, Birmingham, Alabama
Abstract Objective—In the United States (US) sepsis is a major public health problem accounting for over 200,000 annual deaths. The aims of this study were to identify US counties with high sepsis mortality and to assess the community characteristics associated with sepsis mortality.
Author Manuscript
Design—We performed a descriptive analysis of 2003 through 2012 Compressed Mortality File (CMF) data summarized at the county level. We defined sepsis deaths as deaths associated with an infection as the CMF is derived from death certificates and classified according to the International Classification of Diseases, Version 10 (ICD-10). Measurements—We identified county-level sepsis clustering groups: strongly clustered, moderately clustered, and non-clustered. We approximated the mean crude, age-adjusted, and community-adjusted sepsis mortality rates nationally and for clustering groups. We contrasted demographic and community characteristics between clustering groups. We performed logistic regression for the association between strongly clustered counties and community characteristics.
Author Manuscript
Main Results—Among 3,108 US counties, the age-adjusted sepsis mortality rate was 59.6 deaths per 100,000 persons (95% CI: 58.9 – 60.4). Among 161 (5.2%) counties categorized as strongly clustered, the age-adjusted sepsis mortality rate was 93.1 deaths per 100,000 persons (95% CI: 90.5 – 95.7). Strongly clustered sepsis counties were more likely to be located in the South (92.6%, p
Crit Care Med. Author manuscript; available in PMC 2017 July 01. Published in final edited form as: Crit Care Med. 2016 July ; 44(7): 1380–1387. doi:10.1097/CCM.0000000000001665.
Defining Sepsis Mortality Clusters in the United States Justin Xavier Moore, M.P.H1,2, John P. Donnelly, M.S.P.H1,2, Russell Griffin, Ph.D2, Dr. George Howard, P.H.3, Monika M. Safford, M.D.4, and Henry E Wang, M.D., M.S.1 1Department
of Emergency Medicine, University of Alabama School of Medicine, Birmingham,
Alabama
Author Manuscript
2Department
of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama
3Department
of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama
4Department
of Medicine, University of Alabama School of Medicine, Birmingham, Alabama
Abstract Objective—In the United States (US) sepsis is a major public health problem accounting for over 200,000 annual deaths. The aims of this study were to identify US counties with high sepsis mortality and to assess the community characteristics associated with sepsis mortality.
Author Manuscript
Design—We performed a descriptive analysis of 2003 through 2012 Compressed Mortality File (CMF) data summarized at the county level. We defined sepsis deaths as deaths associated with an infection as the CMF is derived from death certificates and classified according to the International Classification of Diseases, Version 10 (ICD-10). Measurements—We identified county-level sepsis clustering groups: strongly clustered, moderately clustered, and non-clustered. We approximated the mean crude, age-adjusted, and community-adjusted sepsis mortality rates nationally and for clustering groups. We contrasted demographic and community characteristics between clustering groups. We performed logistic regression for the association between strongly clustered counties and community characteristics.
Author Manuscript
Main Results—Among 3,108 US counties, the age-adjusted sepsis mortality rate was 59.6 deaths per 100,000 persons (95% CI: 58.9 – 60.4). Among 161 (5.2%) counties categorized as strongly clustered, the age-adjusted sepsis mortality rate was 93.1 deaths per 100,000 persons (95% CI: 90.5 – 95.7). Strongly clustered sepsis counties were more likely to be located in the South (92.6%, p
