Women’s Health
An estimation of sepsis and severe sepsis cases among patients with lactational mastitis in Optum claims data Ruchir Raman* Ruchir Raman Christina Ludema
Background and Justification: Lactational mastitis is an inflammatory breast disease associated with significant maternal morbidity. Its incidence varies from 2.5-20% in breastfeeding mothers, however these rates are generally thought to be underestimated. In a small number of cases, mastitis can progress to sepsis, a serious condition which requires hospitalization and treatment with antibiotics. Although a rare event, there is little information about how many with lactational mastitis postpartum develop or present with sepsis or other bacterial infections during hospitalizations. To this purpose, the current investigation aims to describe the incidence of sepsis among patients who have been hospitalized for lactational mastitis and describe treatment and assess sociodemographic predictors of sepsis.
Methods: We used data from Optum Clinformatics Data Mart from January 1, 2007 – March 31, 2022 for our analysis. Patients with lactation mastitis hospitalizations were identified through ICD 9 codes 675.1 (abscesses of breast associated with childbirth ) and 675.2 (nonpurulent mastitis associated with lactation), and ICD-10 codes O91.13 (abscesses of breast associated with lactation) and O91.23 (nonpurulent mastitis associated with lactation). The subset of patients presenting with sepsis were further identified using ICD-9 and ICD-10 codes obtained from prior literature.
Results: We found 971 patients to be hospitalized with lactational mastitis in the above time period. 59 patients (6.1% hospitalizations) presented with sepsis or severe sepsis, with hospital stays ranging from 1-14 days and median and mean stay lengths of 3 and 3.2 days respectively. A comprehensive analysis of the sociodemographic and antibiotic use characteristics of these sepsis-mastitis patients is currently underway. Understanding these risk factors would be crucial to develop interventions and prevent severe complications in breastfeeding mothers.