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Socio-demographic characteristics associated with hospitalization for sepsis among adults in Canada: a Census-linked cohort study

  • Deirdre A. HennessyEmail author
  • Andrea Soo
  • Daniel J. Niven
  • Rachel J. Jolley
  • Juan Posadas-Calleja
  • Henry T. Stelfox
  • Christopher J. Doig
Reports of Original Investigations
  • 21 Downloads

Abstract

Purpose

Sepsis is a considerable health system burden. Population-based epidemiological surveillance of sepsis is limited to basic data available in administrative databases. We sought to determine if routinely collected Census data, linked to hospitalization data, can provide a broad socio-demographic profile of patients admitted to Canadian hospitals with sepsis.

Methods

Linking the 2006 long-form Canadian Census (most recent available for linkage) to the Discharge Abstract Data from 2006/2007 to 2008/2009, we created a population-based cohort of approximately 3,433,900 Canadians. Patients admitted to hospital with sepsis were identified using the Canadian Institute for Health Information administrative data definition. Age-standardized hospital admission rates for sepsis were calculated. Multivariable modelling was used to examine the relationship between Census characteristics and hospitalization with sepsis.

Results

Of those individuals successfully linked to the 2006 long-form Canadian Census, 10,400 patients of 18 yr and older were admitted to hospital with sepsis between the fiscal years 2006/2007 and 2008/2009. These individuals represented a weighted count of approximately 49,000 Canadians from all provinces and territories, excluding Quebec. The age-standardized rate of sepsis hospitalization was 96 cases/100,000 population. Of these, 37/100,000 cases were classified as severe sepsis. The association of Census characteristics with sepsis hospitalization varied with age. In all age-specific models, male sex, never being married, visible minority status, having functional limitations, and not being in the labour force were associated with an increased odds of hospital admission.

Conclusions

Census data identified broad socio-demographic risk factors for admission to hospital with sepsis. Consideration should be given to incorporating Census data linked to administrative hospital data in population-based epidemiologic surveillance.

Caractéristiques sociodémographiques associées à l’hospitalisation suite à un sepsis chez les adultes au Canada : une étude de cohorte liée au Recensement

Résumé

Objectif

Le sepsis constitue un fardeau considérable pour le système de santé. La surveillance épidémiologique du sepsis sur la population se limite aux données de base disponibles dans les bases de données administratives. Nous avons cherché à déterminer si, en liant les données du Recensement aux données d’hospitalisation, cet ensemble pouvait nous procurer un large profil sociodémographique des patients admis pour traiter un état septique dans les hôpitaux canadiens.

Méthode

En liant le Recensement canadien de 2006 (le plus récent disponible aux fins de liaison) aux Données de la Base de données sur les congés des patients de 2006/2007 à 2008/2009, nous avons créé une cohorte fondée sur une population d’environ 3 433 900 Canadiens. Les patients admis à l’hôpital suite à un sepsis ont été identifiés à l’aide de la définition de l’Institut canadien d’information sur la santé sur les données administratives. Les taux d’admission à l’hôpital standardisés pour l’âge ont été calculés pour le sepsis. Des modèles multivariés ont été utilisés pour examiner la relation entre les caractéristiques du Recensement et l’hospitalisation due à un état septique.

Résultats

Parmi les individus qui ont pu être liés au Recensement canadien de 2006, 10 400 patients de 18 ans ou plus ont été admis à l’hôpital en raison d’un sepsis entre les années financières 2006/2007 et 2008/2009. Ces personnes représentaient un décompte pondéré d’environ 49 000 Canadiens provenant de toutes les provinces et territoires, à l’exclusion du Québec. Le taux d’hospitalisation due au sepsis standardisé pour l’âge était de 96 cas / 100 000 personnes. Parmi ces cas, 37/100 000 ont été catégorisés comme un état septique grave. L’association entre les caractéristiques du Recensement et l’hospitalisation due au sepsis variait en fonction de l’âge. Dans tous les modèles spécifiques en fonction de l’âge, le sexe masculin, le fait de n’avoir jamais été marié, un statut de minorité visible, des limitations fonctionnelles et le fait de ne pas faire partie de la population active étaient associés à une probabilité plus élevée d’admission à l’hôpital.

Conclusion

Les données du Recensement ont permis d’identifier des facteurs de risque sociodémographiques d’admission à l’hôpital pour traiter un état septique. Il faudrait envisager d’intégrer des données du Recensement liées aux données administratives hospitalières pour exercer une surveillance épidémiologique fondée sur la population.

Notes

Author contributions

All authors were involved in the conception, design, and interpretation of the research. Deirdre A. Hennessy acquired the data. Deirdre A. Hennessy and Andrea Soo analyzed the data. Deirdre A. Hennessy drafted the manuscript and all other authors were involved in revising the final version. All authors agree to be accountable for their own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature.

Acknowledgements

The authors acknowledge Gisele Carrière of the Health Analysis Division, Statistics Canada for providing advice and guidance about the Census-linked data. The authors also acknowledge Evelyne Bougie of the Health Analysis Division, Statistics Canada for her review of an earlier draft of the manuscript.

Conflicts of interest

None.

Funding statement

This research was funded by the Health Analysis Division, Statistics Canada and the Department of Critical Care, University of Calgary.

Editorial responsibility

This submission was handled by Dr. Sangeeta Mehta, Associate Editor, Canadian Journal of Anesthesia.

Supplementary material

12630_2019_1536_MOESM1_ESM.docx (141 kb)
Supplementary material 1 (DOCX 141 kb)

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Copyright information

© Canadian Anesthesiologists' Society 2019

Authors and Affiliations

  1. 1.Health Analysis DivisionStatistics CanadaOttawaCanada
  2. 2.Department of Community Health SciencesUniversity of CalgaryCalgaryCanada
  3. 3.Department of Critical Care MedicineUniversity of Calgary and Alberta Health ServicesCalgaryCanada

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