Abstract：
BACKGROUND:Sepsis, the most expensive cause of hospitalization in the United States, is associated with high morbidity and mortality. However, healthcare utilization patterns following sepsis are poorly understood. OBJECTIVE:To identify patient-level factors that contribute to postsepsis mortality and healthcare utilization. DESIGN, SETTING, PATIENTS:A retrospective study of sepsis patients drawn from 21 community-based hospitals in Kaiser Permanente Northern California in 2010. MEASUREMENTS:We determined 1-year survival and use of outpatient and facility-based healthcare before and after sepsis and used logistic regression to identify the factors that contributed to early readmission (within 30 days) and high utilization (≥ 15% of living days spent in facility-based care). RESULTS:Among 6344 sepsis patients, 5479 (86.4%) survived to hospital discharge. Mean age was 72 years with 28.9% of patients aged <65 years. Postsepsis survival was strongly modified by age; 1-year survival was 94.1% for <45 year olds and 54.4% for ≥ 85 year olds. A total of 978 (17.9%) patients were readmitted within 30 days; only a minority of all rehospitalizations were for infection. After sepsis, adjusted healthcare utilization increased nearly 3-fold compared with presepsis levels and was strongly modified by age. Patient factors including acute severity of illness, hospital length of stay, and the need for intensive care were associated with early readmission and high healthcare utilization; however, the dominant factors explaining variability-comorbid disease burden and high presepsis utilization-were present prior to sepsis admission. CONCLUSION:Postsepsis survival and healthcare utilization were most strongly influenced by patient factors already present prior to sepsis hospitalization.
journal_name
J Hosp Medjournal_title
Journal of hospital medicineauthors
Liu V,Lei X,Prescott HC,Kipnis P,Iwashyna TJ,Escobar GJdoi
10.1002/jhm.2197subject
Has Abstractpub_date
2014-08-01 00:00:00pages
502-7issue
8eissn
1553-5592issn
1553-5606journal_volume
9pub_type
杂志文章,多中心研究abstract：BACKGROUND:Unplanned (unexpected) transfers to the intensive care unit (ICU) are typically preceded by physiologic instability. However, trends toward instability may be subtle and not accurately reflected by changes in vital signs. The shock index (SI) (heart rate/systolic blood pressure as an indicator of left ventri...
journal_title：Journal of hospital medicine
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journal_title：Journal of hospital medicine
pub_type： 杂志文章,多中心研究
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pub_type： 杂志文章,评审
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更新日期：2012-05-01 00:00:00
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