title: Risk factors for hospitalization due to community-acquired sepsis - a population-based case-control study.
abstract: BACKGROUND
  The aim of the study was to estimate risk factors for hospitalization due to sepsis and to determine whether these risk factors vary by age and gender.
  
  
  METHODS
  We performed a population-based case-control study of all adult patients admitted to a medical ED from September 2010 to August 2011. Controls were sampled within the hospital catchment-area. All potential cases were manually validated using a structured protocol. Vital signs and laboratory values measured at arrival were registered to define systemic inflammatory response syndrome and organ dysfunction. Multivariable logistic regression was used to elucidate which predefined risk factors were associated with an increased or decreased risk hospitalization due to sepsis.
  
  
  RESULTS
  A total of 1713 patients were admitted with sepsis of any severity. The median age was 72 years (interquartile range: 57-81 years) and 793 (46.3%) were male. 621 (36.3%) patients were admitted with sepsis, 1071 (62.5%) with severe sepsis and 21 (1.2%) with septic shock. Episodes with sepsis of any severity were associated with older age (85+ years adjusted OR 6.02 [95%CI: 5.09-7.12]), immunosuppression (4.41 [3.83-5.09]), alcoholism-related conditions (2.90 [2.41-3.50]), and certain comorbidities: psychotic disorder (1.90 [1.58-2.27]), neurological (1.98 [1.73-2.26]), respiratory (3.58 [3.16-4.06]), cardiovascular (1.62 [1.41-1.85]), diabetes (1.82 [1.57-2.12]), cancer (1.44 [1.22-1.68]), gastrointestinal (1.71 [1.44-2.05]) and renal (1.46 [1.13-1.89]). The strength of the observed associations for comorbid factors was strongest among younger individuals.
  
  
  CONCLUSIONS
  Hospitalization due to sepsis of any severity was associated with several independent risk factors, including age and comorbid factors.
authors.affiliation: Department of Emergency Medicine, Odense University Hospital, DK-5000 Odense C, Denmark.
authors.forename: Daniel Pilsgaard
authors.initials: DP
authors.lastname: Henriksen
authors.affiliation: Clinical Pharmacology, Department of Public Health, University of Southern Denmark, DK-5000 Odense C, Denmark.
authors.forename: Anton
authors.initials: A
authors.lastname: Pottegård
authors.affiliation: Department of Respiratory Medicine, Odense University Hospital, DK-5000 Odense C, Denmark.
authors.forename: Christian B
authors.initials: CB
authors.lastname: Laursen
authors.affiliation: Department of Clinical Microbiology, Odense University Hospital, DK-5000 Odense C, Denmark.
authors.forename: Thøger Gorm
authors.initials: TG
authors.lastname: Jensen
authors.affiliation: Clinical Pharmacology, Department of Public Health, University of Southern Denmark, DK-5000 Odense C, Denmark; Department of Clinical Chemistry & Pharmacology, Odense University Hospital, DK-5000 Odense C, Denmark.
authors.forename: Jesper
authors.initials: J
authors.lastname: Hallas
authors.affiliation: Department of Infectious Diseases, Odense University Hospital, DK-5000 Odense C, Denmark.
authors.forename: Court
authors.initials: C
authors.lastname: Pedersen
authors.affiliation: Department of Emergency Medicine, Odense University Hospital, DK-5000 Odense C, Denmark.
authors.forename: Annmarie Touborg
authors.initials: AT
authors.lastname: Lassen
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D016022:Case-Control Studies; D017714:Community-Acquired Infections; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000401:mortality; D012307:Risk Factors; D018805:Sepsis / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D012720:Severity of Illness Index; D012737:Sex Factors; D016019:Survival Analysis