Deeply phenotyped sepsis patients within hospital: onset, treatments & outcomes

Sepsis is life-threatening organ dysfunction due to a dysregulated host response to infection & is a global health challenge. In 2017, 48•9 million incident cases of sepsis were recorded worldwide with 11million sepsis-related deaths, representing 19•7% of all global deaths. There are >123,000 sepsis cases diagnosed in Engl& each year with an estimated 36,800 sepsis-associated deaths. Sepsis is treatable, & timely, targeted interventions improve outcomes. The World Health Assembly identified sepsis as a global health priority.

PIONEER geography The West Midlands (WM) has a population of 5.9 million & includes a diverse ethnic & socio-economic mix. There is a higher than average percentage of minority ethnic groups. WM has a large number of elderly residents but is the youngest population in the UK. Birmingham has the highest birth rate in England. It also has the highest infant mortality rate. WM life expectancy is 1.8 years less than in London. There are particularly high rates of physical inactivity, obesity, smoking & diabetes. Each day >100,000 people are treated in hospital, see their GP or are cared for by the NHS.

EHR. University Hospitals Birmingham NHS Foundation Trust (UHB) is one of the largest NHS Trusts in England, providing direct acute services & specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds & 100 ITU beds. UHB runs a fully electronic healthcare record (EHR) (PICS; Birmingham Systems), a shared primary & secondary care record (Your Care Connected) & a patient portal “My Health”.

Scope: All hospitalised patients to UHB from 2000 – current day. Updated monthly. Longitudinal & individually linked, so that the preceding & subsequent health journey can be mapped & healthcare utilisation prior to & after sepsis understood. The dataset includes ICD-10 & SNOMED-CT codes pertaining to sepsis & suspected sepsis. Serial, structured data pertaining to process of care (timings, staff grades, specialty review, wards), presenting complaint, all physiology readings (pulse, blood pressure, respiratory rate, oxygen saturations), all blood results, microbiology, all prescribed & administered treatments (fluids, antibiotics, inotropes, vasopressors, organ support), all outcomes. Linked images available (radiographs, CT, MRI, ultrasound). Includes COVID-19 wave 1 and wave 2 data.

Available supplementary data: Matched “non-sepsis” controls; ambulance, 111, 999 data, synthetic data.

Available supplementary support: Analytics, Model build, validation & refinement; A.I.; Data partner support for ETL (extract, transform & load) process, Clinical expertise, Patient & end-user access, Purchaser access, Regulatory requirements, Data-driven trials, “fast screen” services.