While advances in the understanding of sepsis have led to improved management and outcomes for patients with septic shock, a recent study published in Critical Care Medicine by researchers at the University of Pennsylvania describe a troubling increase in 30-day hospital readmission rates for survivors of septic shock.
In this retrospective analysis, Mark Mikkelsen, MD, Perelman School of Medicine at University of Pennsylvania, and colleagues examined data from 269 patients admitted to one of three University of Pennsylvania Health System hospitals between 2007 and 2010 with a diagnosis of septic shock and discharged to a non-hospice setting. Twenty-three percent of these patients analyzed returned to the hospital within 30 days, a rate significantly higher than the normal readmission rate at a typical large academic medical center.
In nearly 80 percent of these patients, the reason for readmission was directly related to the initial and/or unresolved sepsis hospitalization. One out of six readmissions resulted in death or patient transition to hospice care. “We have come so far in understanding how to tame the initial infection that we have minimal understanding of what life is like for these patients once they leave the hospital,” Mikkelson noted.
Patients who were readmitted to the hospital were typically found to either have cirrhosis, cancer, or a recent prolonged hospital stay. Further examination of patient trends associated with readmission will be especially critical as the Centers for Medicare and Medicaid Services expand readmission penalties for patients with sepsis.
Ortego et al. Hospital-Based Acute Care Use in Survivors of Septic Shock. Crit Care Med. 2014; doi: 10. 1097/CCM.0000000000000693