Background Sepsis causes a major health burden in the United States. To better understand the role of sepsis as a driver of the burden and cost of foodborne illness in the United States, we estimated the frequency and treatment cost of sepsis among US patients hospitalized with 31 pathogens commonly transmitted through food or with unspecified acute gastrointestinal illness (AGI). Methods Using data from the National Inpatient Sample from 2012 to 2015, we identified sepsis hospitalizations using 2 approaches—explicit ICD-9-CM codes for sepsis and a coding scheme developed by Angus that identifies sepsis using specific ICD-9-CM diagnosis codes indicating an infection plus organ failure. We examined differences in the frequency and the per-case cost of sepsis across pathogens and AGI and estimated total hospitalization costs using prior estimates of foodborne hospitalizations. Results Using Explicit Sepsis Codes, sepsis hospitalizations accounted for 4.6% of hospitalizations with a pathogen commonly transmitted through food or unspecified AGI listed as a diagnosis; this was 33.2% using Angus Sepsis Codes. The average per-case cost was $35 891 and $20 018, respectively. Applying the proportions of hospitalizations with sepsis from this study to prior estimates of the number foodborne hospitalizations, the total annual cost was $248 million annually using Explicit Sepsis Codes and $889 million using Angus Sepsis Codes. Conclusions Sepsis is a serious complication among patients hospitalized with a foodborne pathogen infection or AGI resulting in a large burden of illness. Hospitalizations that are diagnosed using explicit sepsis codes are more severe and costly, but likely underestimate the burden of foodborne sepsis.

中文翻译：

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从食源性住院中识别脓毒症：病原体的发病率和住院费用

背景败血症在美国造成重大的健康负担。为了更好地了解脓毒症作为美国食源性疾病负担和成本驱动因素的作用，我们估计了因 31 种通常通过食物传播的病原体或未明确的急性胃肠道疾病而住院的美国患者脓毒症的发生频率和治疗费用（通用人工智能）。方法 使用 2012 年至 2015 年全国住院患者样本的数据，我们使用 2 种方法确定脓毒症住院治疗——针对脓毒症的明确 ICD-9-CM 代码和 Angus 开发的使用特定 ICD-9-CM 诊断代码识别脓毒症的编码方案表明感染加上器官衰竭。我们检查了病原体和 AGI 之间败血症的频率和每例成本的差异，并使用先前对食源性住院的估计来估计总住院成本。结果 使用明确的脓毒症代码，脓毒症住院占住院的 4.6%，病原体通常通过食物传播或被列为诊断的未指定 AGI；这是 33.2%，使用安格斯败血症代码。每个案例的平均成本分别为 35 891 美元和 20 018 美元。将本研究中因脓毒症住院的比例应用于之前对食源性住院人数的估计，使用明确脓毒症代码的年度总成本为 2.48 亿美元，使用安格斯脓毒症代码的年度总成本为 8.89 亿美元。结论 脓毒症是因食源性病原体感染或 AGI 住院的患者的严重并发症，会导致很大的疾病负担。使用明确的脓毒症代码诊断的住院治疗更严重且成本更高，但可能低估了食源性脓毒症的负担。