Independent predictors for 90-day readmission of emergency department patients admitted with sepsis: a prospective cohort study

Autor: Rune Husås Sørensen, S M Osama Bin Abdullah, Peer Oscar Overgaard Stenholt, Finn Erland Nielsen
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Male
medicine.medical_specialty
Time Factors
Organ Dysfunction Scores
Population
Diuretics/therapeutic use
030204 cardiovascular system & hematology
Neoplasms/pathology
Patient Readmission
lcsh:Infectious and parasitic diseases
Cohort Studies
Sepsis
03 medical and health sciences
0302 clinical medicine
Risk Factors
Interquartile range
Neoplasms
Internal medicine
medicine
Humans
lcsh:RC109-216
Prospective Studies
030212 general & internal medicine
Diuretics
Prospective cohort study
education
Aged
Aged
80 and over
Analysis of Variance
education.field_of_study
business.industry
Emergency department
Predictors
Middle Aged
medicine.disease
Confidence interval
Infectious Diseases
Heart failure
Female
Patient Readmission/statistics & numerical data
Emergency Service
Hospital
business
Readmission
Sepsis/pathology
Research Article
Cohort study
Zdroj: BMC Infectious Diseases, Vol 21, Iss 1, Pp 1-10 (2021)
BMC Infectious Diseases
Stenholt, P O O, Abdullah, S M O B, Sørensen, R H & Nielsen, F E 2021, ' Independent predictors for 90-day readmission of emergency department patients admitted with sepsis : a prospective cohort study ', BMC Infectious Diseases, vol. 21, 315 . https://doi.org/10.1186/s12879-021-06007-9
ISSN: 1471-2334
DOI: 10.1186/s12879-021-06007-9
Popis: Background The primary objective of our study was to examine predictors for readmission in a prospective cohort of sepsis patients admitted to an emergency department (ED) and identified by the new Sepsis-3 criteria. Method A single-center observational population-based cohort study among all adult (≥18 years) patients with sepsis admitted to the emergency department of Slagelse Hospital during 1.10.2017–31.03.2018. Sepsis was defined as an increase in the sequential organ failure assessment (SOFA) score of ≥2. The primary outcome was 90-day readmission. We followed patients from the date of discharge from the index admission until the end of the follow-up period or until the time of readmission to hospital, emigration or death, whichever came first. We used competing-risks regression to estimate adjusted subhazard ratios (aSHRs) with 95% confidence intervals (CI) for covariates in the regression models. Results A total of 2110 patients were admitted with infections, whereas 714 (33.8%) suffered sepsis. A total of 52 patients had died during admission and were excluded leaving 662 patients (44.1% female) with a median age of 74.8 (interquartile range: 66.0–84.2) years for further analysis. A total of 237 (35,8%; 95% CI 32.1–39.6) patients were readmitted within 90 days, and 54(8.2%) had died after discharge without being readmitted. We found that a history of malignant disease (aSHR 1,61; 1.16–2.23), if previously admitted with sepsis within 1 year before the index admission (aSHR; 1.41; 1.08–1.84), and treatment with diuretics (aSHR 1.51; 1.17–1.94) were independent predictors for readmission. aSHR (1.49, 1.13–1.96) for diuretic treatment was almost unchanged after exclusion of patients with heart failure, while aSHR (1.47, 0.96–2.25) for malignant disease was slightly attenuated after exclusion of patients with metastatic tumors. Conclusions More than one third of patients admitted with sepsis, and discharged alive, were readmitted within 90 days. A history of malignant disease, if previously admitted with sepsis, and diuretic treatment were independent predictors for 90-day readmission.
Databáze: OpenAIRE
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