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Forty percent of hospitalizations after severe sepsis are potentially preventable
© Prescott et al.; licensee BioMed Central Ltd. 2014
Published: 3 December 2014
Patients are frequently rehospitalized in the 90 days after severe sepsis. The rate of readmission exceeds patients' baseline rate of hospitalization, and also exceeds the rate after matched nonsepsis hospitalizations . We sought to determine the most common readmission diagnoses after severe sepsis, the extent to which readmissions may be preventable, and whether the pattern of readmission diagnoses differs from that of nonsepsis hospitalizations.
We studied participants in the US Health and Retirement Study with linked Medicare claims (1998 to 2010) . Using validated methods [3, 4], we identified severe sepsis and nonsepsis hospitalizations, then measured 90-day readmissions in each cohort. Using Healthcare Cost & Utilization Project's Clinical Classification Software , we determined the 10 most common readmission diagnoses after severe sepsis. We measured rates of 'potentially preventable' readmissions using published definitions . We compared rates of all-cause, potentially preventable, and cause-specific hospitalizations between survivors of severe sepsis and nonsepsis hospitalizations using chi-squared tests.
Top ten hospitalization diagnoses in the 90 days following severe sepsis.
Proportion of all 90-day admissions (%)
Survivors with 90-day admission (%)
Congestive heart failure, nonhypertensive
Acute and unspecified renal failure
Complication of device, implant, or graft
COPD and bronchiectasis
Urinary tract infection
Forty percent of hospitalizations after severe sepsis occur for diagnoses that may be preventable. A few disease categories account for a relatively large proportion of the hospitalizations after severe sepsis, suggesting the feasibility of tailoring postdischarge interventions to patient's personalized risk for these common postsepsis diagnoses.
The authors declare financial support from the US National Institutes of Health and the US Department of Veteran's Affairs. There are no potential conflicts of interest. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the US government.
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