title: Epidemiology of severe sepsis: 2008-2012.
abstract: BACKGROUND
  Severe sepsis continues to be a significant burden on society.
  
  
  METHODS
  Using the International Classification of Diseases, Ninth Revision, Clinical Modification codes, we analyzed the Healthcare Cost and Utilization Project National Inpatient Sample in order to estimate epidemiologic trends of severe sepsis from the years 2008 to 2012. The 2010 US Census, which included 308,745,538 individuals, was used to calculate incidence per 100,000 persons.
  
  
  RESULTS
  There were a total of 6,067,789 discharges for severe sepsis. The annual incidence increased from 346/100,000 to 436/100,000 persons (P < .05). Individuals with 3 or greater organ system failures increased from 31.6% to 35.5% (P < .05), and they accounted for 57.2% to 66.7% of the total number of deaths. Overall mortality decreased from 22.2% to 17.3% (P < .05). Length of stay decreased from 9 to 7 days (P < .05). Those discharged to home with and without home-health increased (23%-27%; P < .05), but those discharged to skilled nursing facilities remained the same (35%).
  
  
  CONCLUSIONS
  The incidence of severe sepsis continues to increase, whereas mortality decreases. However, one third of patients (those with ≥3 organ system failures) account for two thirds of the total number of deaths. More people are discharged home, whereas stable numbers go to facilities.
authors.affiliation: Department of Surgery, University of Toledo Medical Center, Toledo, OH. Electronic address: jeremy.stoller@utoledo.edu.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Stoller
authors.affiliation: Department of Surgery, University of Toledo Medical Center, Toledo, OH.
authors.forename: Laura
authors.initials: L
authors.lastname: Halpin
authors.affiliation: Department of Surgery, University of Toledo Medical Center, Toledo, OH.
authors.forename: Matthew
authors.initials: M
authors.lastname: Weis
authors.affiliation: Department of Surgery, University of Toledo Medical Center, Toledo, OH.
authors.forename: Brett
authors.initials: B
authors.lastname: Aplin
authors.affiliation: Department of Surgery, University of Toledo Medical Center, Toledo, OH.
authors.forename: Weikai
authors.initials: W
authors.lastname: Qu
authors.affiliation: Department of Medicine, University of Toledo Medical Center, Toledo, OH.
authors.forename: Claudiu
authors.initials: C
authors.lastname: Georgescu
authors.affiliation: Department of Surgery, University of Toledo Medical Center, Toledo, OH.
authors.forename: Munier
authors.initials: M
authors.lastname: Nazzal
mesh_terms: D000328:Adult; D000368:Aged; D006699:Home Care Services / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D038801:International Classification of Diseases; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000150:complications; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology* / Q000401:mortality; D014481:United States / Q000453:epidemiology
keywords: Epidemiology; Incidence; Mortality; Organ failure; Severe sepsis