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dc.contributor.authorShahul, Sajiden_US
dc.contributor.authorHacker, Michele R.en_US
dc.contributor.authorNovack, Victoren_US
dc.contributor.authorMueller, Arielen_US
dc.contributor.authorShaefi, Shahzaden_US
dc.contributor.authorMahmood, Bilalen_US
dc.contributor.authorAli, Syed Haideren_US
dc.contributor.authorTalmor, Danielen_US
dc.date.accessioned2014-11-03T17:38:36Z
dc.date.issued2014en_US
dc.identifier.citationShahul, Sajid, Michele R. Hacker, Victor Novack, Ariel Mueller, Shahzad Shaefi, Bilal Mahmood, Syed Haider Ali, and Daniel Talmor. 2014. “The Effect of Hospital Volume on Mortality in Patients Admitted with Severe Sepsis.” PLoS ONE 9 (9): e108754. doi:10.1371/journal.pone.0108754. http://dx.doi.org/10.1371/journal.pone.0108754.en
dc.identifier.issn1932-6203en
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:13347441
dc.description.abstractImportance The association between hospital volume and inpatient mortality for severe sepsis is unclear. Objective: To assess the effect of severe sepsis case volume and inpatient mortality. Design Setting and Participants Retrospective cohort study from 646,988 patient discharges with severe sepsis from 3,487 hospitals in the Nationwide Inpatient Sample from 2002 to 2011. Exposures The exposure of interest was the mean yearly sepsis case volume per hospital divided into tertiles. Main Outcomes and Measures Inpatient mortality. Results: Compared with the highest tertile of severe sepsis volume (>60 cases per year), the odds ratio for inpatient mortality among persons admitted to hospitals in the lowest tertile (≤10 severe sepsis cases per year) was 1.188 (95% CI: 1.074–1.315), while the odds ratio was 1.090 (95% CI: 1.031–1.152) for patients admitted to hospitals in the middle tertile. Similarly, improved survival was seen across the tertiles with an adjusted inpatient mortality incidence of 35.81 (95% CI: 33.64–38.03) for hospitals with the lowest volume of severe sepsis cases and a drop to 32.07 (95% CI: 31.51–32.64) for hospitals with the highest volume. Conclusions and Relevance We demonstrate an association between a higher severe sepsis case volume and decreased mortality. The need for a systems-based approach for improved outcomes may require a high volume of severely septic patients.en
dc.language.isoen_USen
dc.publisherPublic Library of Scienceen
dc.relation.isversionofdoi:10.1371/journal.pone.0108754en
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4181313/pdf/en
dash.licenseLAAen_US
dc.subjectMedicine and Health Sciencesen
dc.subjectCritical Care and Emergency Medicineen
dc.subjectCritical Care Team Organizationen
dc.subjectHealth Careen
dc.subjectHealth Services Administration and Managementen
dc.subjectHealth Services Researchen
dc.titleThe Effect of Hospital Volume on Mortality in Patients Admitted with Severe Sepsisen
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden
dc.relation.journalPLoS ONEen
dash.depositing.authorHacker, Michele R.en_US
dc.date.available2014-11-03T17:38:36Z
dc.identifier.doi10.1371/journal.pone.0108754*
dash.contributor.affiliatedShaefi, Shahzad
dash.contributor.affiliatedTalmor, Daniel
dash.contributor.affiliatedHacker, Michele


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