Sepsis at a Safety Net Hospital: Risk Factors Associated With 30-Day Readmission
| Autor: | Rosechelle M. Ruggiero, Mark Weinreich, Shelley Chang, Kim Styrvoky, Carlos E. Girod |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Safety net Medically Underserved Area Comorbidity Critical Care and Intensive Care Medicine Patient Readmission Sepsis 03 medical and health sciences 0302 clinical medicine Risk Factors medicine Odds Ratio Humans Intensive care medicine Retrospective Studies Hospital readmission business.industry 030208 emergency & critical care medicine Middle Aged medicine.disease Texas 030228 respiratory system Emergency medicine Kidney Failure Chronic Female business Safety-net Providers |
| Zdroj: | Journal of intensive care medicine. 34(11-12) |
| ISSN: | 1525-1489 |
| Popis: | Background: Sepsis is a leading cause of hospitalization, and subsequent readmissions are frequent and costly. There is an expanding body of literature describing risk factors for readmissions in patients with sepsis. However, there are little data studying medically underserved patients who typically receive their care at a safety net hospital. Methods: In a retrospective cohort study, we evaluated 1355 sepsis survivors at risk of hospital readmission in fiscal year 2013 at a safety net hospital. We described patient characteristics during their initial and readmission hospitalizations and analyzed risk factors associated with 30-day readmission. Results: The 30-day readmission rate among sepsis survivors was 22.6%. Comorbid conditions associated with readmissions included end-stage renal disease (odds ratio [OR], 1.26; 95% confidence interval [CI], 1.17-1.36), malignancy (OR, 1.14; 95% CI, 1.08-1.21), and cirrhosis (OR, 1.11; 95% CI, 1.02-1.20). Bacteremia during the initial hospitalization (OR, 1.07; 95% CI, 1.01-1.15) and being discharged with a vascular catheter (OR, 1.10; 95% CI, 1.01-1.20) were associated with readmission. Less severe sepsis during the initial hospitalization was associated with a reduced risk of 30-day readmission (OR, 0.91; 95% CI, 0.87-0.94). Conclusions: At a safety net hospital, patients who survived their initial sepsis hospitalization had a 30-day readmission rate to our institution of 22.6% that is comparable to rates described in prior studies. Readmission was commonly due to infection. Factors associated with readmission included multiple comorbid medical conditions, bacteremia, and being discharged with a vascular catheter. Further studies in this population are needed to determine potential modifiability of these risk factors in an attempt to reduce sepsis readmissions. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|