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Frequency of and Risk Factors Associated With Hospital Readmission After Sepsis.
Dashefsky, Hannah S; Liu, Hongyan; Hayes, Katie; Griffis, Heather; Vaughan, Melissa; Chilutti, Marianne; Balamuth, Fran; Stinson, Hannah R; Fitzgerald, Julie C; Carlton, Erin F; Weiss, Scott L.
Afiliación
  • Dashefsky HS; Departments of Anesthesiology and Critical Care.
  • Liu H; Pediatric Sepsis Program.
  • Hayes K; Data Science and Biostatistics Unit, Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
  • Griffis H; Pediatric Sepsis Program.
  • Vaughan M; Data Science and Biostatistics Unit, Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
  • Chilutti M; Departments of Anesthesiology and Critical Care.
  • Balamuth F; Biomedical and Health Informatics.
  • Stinson HR; Arcus Program, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
  • Fitzgerald JC; Pediatrics.
  • Carlton EF; Pediatric Sepsis Program.
  • Weiss SL; Departments of Anesthesiology and Critical Care.
Pediatrics ; 152(1)2023 Jul 01.
Article en En | MEDLINE | ID: mdl-37366012
OBJECTIVES: Although children who survive sepsis are at risk for readmission, identification of patient-level variables associated with readmission has been limited by administrative datasets. We determined frequency and cause of readmission within 90 days of discharge and identified patient-level variables associated with readmission using a large, electronic health record-based registry. METHODS: This retrospective observational study included 3464 patients treated for sepsis or septic shock between January 2011 and December 2018 who survived to discharge at a single academic children's hospital. We determined frequency and cause of readmission through 90 days post-discharge and identified patient-level variables associated with readmission. Readmission was defined as inpatient treatment within 90 days post-discharge from a prior sepsis hospitalization. Outcomes were frequency of and reasons for 7-, 30-, and 90-day (primary) readmission. Patient variables were tested for independent associations with readmission using multivariable logistic regression. RESULTS: Following index sepsis hospitalization, frequency of readmission at 7, 30, and 90 days was 7% (95% confidence interval 6%-8%), 20% (18%-21%), and 33% (31%-34%). Variables independently associated with 90-day readmission were age ≤ 1 year, chronic comorbid conditions, lower hemoglobin and higher blood urea nitrogen at sepsis recognition, and persistently low white blood cell count ≤ 2 thous/µL. These variables explained only a small proportion of overall risk (pseudo-R2 range 0.05-0.13) and had moderate predictive validity (area under the receiver operating curve range 0.67-0.72) for readmission. CONCLUSIONS: Children who survive sepsis were frequently readmitted, most often for infections. Risk for readmission was only partly indicated by patient-level variables.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Readmisión del Paciente / Sepsis Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Child / Humans Idioma: En Revista: Pediatrics Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Readmisión del Paciente / Sepsis Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Child / Humans Idioma: En Revista: Pediatrics Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos