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

Peer Oscar Overgaard Stenholt*, S. M.Osama Bin Abdullah, Rune Husås Sørensen, Finn Erland Nielsen

*Kontaktforfatter for dette arbejde

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Abstrakt

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.

OriginalsprogEngelsk
Artikelnummer315
TidsskriftBMC Infectious Diseases
Vol/bind21
Antal sider10
ISSN1471-2334
DOI
StatusUdgivet - dec. 2021

Bibliografisk note

Funding Information:
This project received financial support from Region Zealand Health Research Foundation and Naestved, Slagelse and Ringsted Hospitals Research Fund. The funders did not have any role in the study design, aim, or process.

Publisher Copyright:
© 2021, The Author(s).

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