Agency News and Notes

Southeastern and mid-Atlantic States have highest rate of sepsis-related deaths

Infections may lead to death by triggering systemic inflammation (sepsis), which, in turn, can lead to organ dysfunction and shock. Sepsis results in 570,000 emergency department (ED) visits and approximately 200,000 deaths each year in the United States. A new study has identified a group of contiguous States with an increased adult death rate from sepsis that is comparable with the "stroke belt" for deaths from cerebrovascular disease. These States had an estimated 8,500 excess adult sepsis deaths annually over that expected from the national average. This finding of regional variation in sepsis deaths may lead to identifying populations more vulnerable to sepsis and needing more attention to sepsis prevention or geographic regions needing improved sepsis care in the ED or hospital, note the researchers.

From 1999 to 2005, there were slightly over 1 million deaths in the United States due to sepsis among persons at least 15 years old, giving a national age-adjusted mortality rate of 65.9 deaths per 100,000 persons. Excluding the District of Columbia, there was a twofold variation in age-adjusted sepsis mortality by State (41 to 88.6 deaths per 100,000 people annually for Minnesota and Maryland, respectively, with a median of 60.8 deaths per 100,000).

The researchers identified a cluster of 11 adjacent States in the Southeastern and mid-Atlantic regions with the highest infection death rates (29 percent higher, overall, than the rest of the country). They used information from the National Center for Health Statistics' Compressed Mortality Files for 1999 through 2005, which gave both death incidence and geographic distribution by State for different disease groups, together with U.S. Census Bureau population estimates.

The study was funded in part by the Agency for Healthcare Research and Quality (HS13628). More details are in "National variation in United States sepsis mortality: A descriptive study," by Henry E. Wang, M.D., M.S., Randolph S. Devereaux, M.S.P.H., Donald M. Yealy, M.D., and others in the February 15, 2010, International Journal of Health Geographics, available online at http://www.ij-healthgeographics.com/content/9/1/9.

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