Gadre et al identified risk factors for hospital readmission for a patient with sepsis. A patient with one or more of these risk factors may benefit from more aggressive management. The authors are from the Cleveland Clinic and Lehigh Valley Health Network (Allentown).
Patient selection: index admission with a diagnosis of sepsis
Outcome: 30-day hospital readmission (25% occur within 5 days; 50% within 11days)
Indications for readmission:
(1) infection (42%)
(2) gastrointestinal, hepatic or pancreatic
(3) cardiovascular
(4) pulmonary
(5) renal
Risk factors for readmission:
(1) diabetes mellitus
(2) chronic kidney disease
(3) congestive heart failure
(4) discharge to a short or long-term care facility (not discharged home)
(5) Charlson Comorbidity Index >= 2
(6) length of index admission >= 3 days
(7) malignancy
Patient age > 80 years is associated with a reduced 30-day readmission rate, perhaps due to greater use of palliative care and hospice.
