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The following is a summary of “Geographic Clusters in Sepsis Hospital Mortality and the Role of Targeted Regionalization,” published in the April 2025 issue of Critical Care Medicine by Mohr et al. 

Researchers conducted a retrospective study to develop geospatial sepsis clusters, examine sources of variation between them, and evaluate whether reallocating individuals with sepsis from lower- to higher-performing hospitals within clusters improved outcomes.  

They analyzed Medicare beneficiaries (age-qualifying) using administrative claims data from 2013 to 2015. They calculated the risk-standardized mortality for hospitals and applied a clustering algorithm to define geospatial cluster boundaries based on care-seeking and interhospital transfer patterns. The simulation was then used to model the impact of reallocating patients with sepsis to higher-performing hospitals within the same cluster.  

The results showed that 1,125,308 Medicare beneficiaries (age-qualifying) were grouped into 222 regional clusters. High-performing clusters were primarily located in the Midwest, often in less urban areas with smaller hospitals. In the simulation, reassigning cases from the lowest- to highest-performing hospital within a cluster was the most impactful strategy, potentially preventing 1,705 deaths annually in the United States. This benefit was lower than the 5,702 deaths predicted from a 1% reduction in mortality at hospitals in the lower half of the performance allocation.  

Investigators concluded that targeted sepsis regionalization had appeared less influential than local performance improvement in lowering preventable sepsis deaths, based on a simulation study that provided insight into regional approaches to system-based acute care. 

Source: journals.lww.com/ccmjournal/abstract/9900/geographic_clusters_in_sepsis_hospital_mortality.516.aspx