PIN98 NATIONAL BURDEN OF SEPSIS IN INDONESIA: AN ANALYSIS BASED ON FOCAL INFECTIONS

To describe the burden of sepsis by focal infection in Indonesian hospitals. We performed a retrospective observational study of patients with sepsis in four centers in Indonesia based on inpatient registry and hospital discharge data from January 1, 2013 to December 31, 2016. The billing records include bed cost, drug cost, laboratory and radiology costs, and total costs. Using the Sequential Organ Failure Assessment (SOFA) criteria for sepsis, we included all sepsis cases with patients aged greater than or equal to 18 years. We categorized costs separetely for surviving and deceased patients into the following groups: Respiratory Tract Infections (RTIs), Urinary Tract Infections (UTIs), Gastrointestinal Infections (GIIs), Neuromuscular Infections (NMIs), Wound Infections (WIs), Cardiovascular Infections (CVIs), Unidentified Focal Infections (UFIs), and multifoci infections. We addressed the national burden of sepsis based on an Indonesia Case Base Group (INA-CBG) study of five regions (34 provinces). Of 14,076 patients, 8,701 survived (61.8%) with sepsis. Sepsis with multifoci infections was the most prevalent (n=4,304; 30.6%) followed by UFI (n=1,637; 11.6%), RTIs (n=3,932; 27.9%), UTIs (n=1,348; 9.6%), GIIs (n=1,328; 9.4%), WIs (n=1,049; 7.5%), NMIs (n=368; 2.6%), and CVIs (n=110; 0.8%). The mean costs for surviving and deceased sepsis cases were US$ 1,072.63 (95%CI: 105.41-3,625.69) and US$ 1,380.07 (95%CI: 127.00-4,827.56), respectively. Among the surviving patients, sepsis with WIs had the highest mean costs (US$ 1,721.59). For national burden, sepsis with RTIs had the highest cost (US$ 48,715,756.58) followed by sepsis with WIs (US$ 17,553,541.10), UTIs (US$ 11,903,389.38), GIIs (US$ 8,655,742.23), NMIs (US$ 3,101,664.65), and CVIs (US$ 1,739,324.04). Deceased sepsis patients presented higher costs than surviving patients. RTIs and WIs should be considered high-burden sepsis cases in Indonesia.