Last update: 20240919

National sepsis registry

The precision medicine unit can act as a leading user for a national sepsis registry. Our analysis of public and private data allow us to accurately measure the number of cases per year in all institutions. We can also provide examples of key data that is most valuable including routing clinical and demographic features, examples of how databases are structured, and example of how advance statistical analysis can use this data in daily management and research projects in combination with new technologies. Figure 1{reference-type=”ref” reference=”fig:national_registry1”} (summary) and 2{reference-type=”ref” reference=”fig:national_registry2”} (detailed) illustrates how we can accurate model the requirements of a national registry database:

• We can state that the total number of sepsis cases for 2010-2022 was 368’719. A typical year (2022) had 35’205 cases with per-institution averages of 22 (sd: 57, min-max 0-600). The total subset of primary and secondary diagnosis during this period was 245’552.

• We can give a breakdown of estimated numbers accurate for each institution.

• We can identify the key players which have the largest number of adult and child cases (e.g. Insel Gruppe, Universitatsspital Zurich, Kantonsspital Baselland).

• We can reproduce the numbers of main diagnosis per year as reported by FOPH BAG and OBSAN, shown in table 1{reference-type=”ref” reference=”tab:year_report”}.

::: {#tab:year_report}

Diagnosis Total Number of Cases Number of Hospitalisations Average Number of Cases per Hospital

————— ————————— ——————————– ——————————————

J.2.1.F HD 11’782 109 108

J.2.4.F ND 5’541 103 54

Number of cases in 2022. HD (Hauptdiagnose) und ND (Nebendiagnose), HD and ND are German abbreviations for Principal and Secondary diagnoses, respectively. :::

[[tab:year_report]]{#tab:year_report label=”tab:year_report”}

The database for a Swiss national sepsis registry until spanning from 2010-2030 will contain 400’000 cases. For each case it will contain at least a minimal set of 40 demographic and clinical data variables. We can advise on the architecture of the database and recommend commercial solutions for hosting a secure and accessible platform.

{#fig:national_registry1 width=”90%”}

{#fig:national_registry2 width=”90%”}

{#fig:national_registry_snapshot width=”100%”}

Figure 3{reference-type=”ref” reference=”fig:national_registry_snapshot”} shows a snapshot of the demo national sepsis registry. We have included variables that cover the minimal set of features and provide a number of optional advanced features which are important to research and future development. Table 2{reference-type=”ref” reference=”tab:national_registry_example”} shows an example of features and data types that are captured. The current modelled variables contain: Patient_ID, Age, Gender, Diagnosis_Code, Source_of_Infection, Organ_Dysfunction, Treatment_Administered, AMS_Compliance, National_Sepsis_Pathway_Used, Outcome, Sepsis_Standard_Met, Date_Admission, Date_Discharge, Date_Follow_up, study_site, sex, age_at_bc_days, age_grp, ethnicity, category, ccc_final, hosp_sepsis, hosp_delay, hosp_los, hosp_los_bc, pathogen_grp, focus_grp, picu, picu_reason, picu_los, picu_los_bc, cahai, death_30_bc, death_delay, cons05_score_agg, pelod_score_agg, psofa_score_agg, podium_score_agg.

::: {#tab:national_registry_example}

Field Name Data Type Description

——————————— ———————————————————————————————- ——————————————————————————————–

Patient_ID String A unique identifier for each patient to ensure privacy and enable tracking.

Age Integer Age of the patient at the time of admission.

Gender Char(1) Gender of the patient (M for male, F for female).

Admission_Date Date Date when the patient was admitted to the hospital.

Discharge_Date Date Date when the patient was discharged from the hospital.

Diagnosis_Code ICD-10 Code ICD-10 code for sepsis (e.g., A41.9 for sepsis, unspecified organisms).

Source_of_Infection String The likely source or site of the infection leading to sepsis.

Organ_Dysfunction Enum("Renal", "Cardiovascular", "Respiratory", "Hepatic", "Multiorgan", "Other") Specific organs affected by sepsis.

Treatment_Administered Text Key treatments provided to the patient (e.g., antibiotics, vasopressors, supportive care).

AMS_Compliance Boolean Indicates whether antimicrobial stewardship (AMS) guidelines were followed (Yes/No).

National_Sepsis_Pathway_Used Boolean Indicates if a national sepsis pathway was followed for treatment (Yes/No).

Outcome Enum("Survived", "Deceased") Patient’s condition at discharge.

Follow_up_Date Date Date for a follow-up visit or assessment, if applicable.

Sepsis_Standard_Met Boolean Indicates whether the minimal national sepsis standard for care was met (Yes/No).

Example subset of registry data fields :::

[[tab:national_registry_example]]{#tab:national_registry_example label=”tab:national_registry_example”}