Michael Young
OhioHealth Riverside Methodist Hospital
Columbus, Ohio
Disclosure information not submitted.
Jordan DeWitt, BCCCP, BCPS, PharmD
Medical ICU Pharmacist
Riverside Methodist Hospital OhioHealth
Disclosure information not submitted.
Brian Peifer, PharmD, BCPS
Pharmacist Informaticist
OhioHealth Riverside Methodist Hospital, United States
Disclosure information not submitted.
John Elliott, PhD, MPH
Sr Consult Academic Research
OhioHealth, United States
Disclosure information not submitted.
Title: Identifying 30 day sepsis readmission risk factors
Introduction:
Among Medicare beneficiaries, those initially admitted to the hospital for sepsis have the second highest readmission rates. Readmissions following sepsis have increasingly gained scrutiny by Centers for Medicare and Medicaid Services (CMS). Limited research exists on factors that contribute to sepsis readmissions. Available literature suggests that demographic factors and certain comorbidities play a role in increased readmission rates, but in-hospital factors and preventative measures are unknown.
Methods:
We describe a multicenter, case-control study analyzing risk and protective factors among those who were and were not readmitted within 30 days following an intensive care unit (ICU) admission at five hospitals for sepsis and/or septic shock from January 1st 2017 through December 31st 2019. Highlighted primary outcome risk factors revolve around medications received in the ICU, infection control measures, procedures, and disposition. Secondary outcomes include the impact of pharmacist involvement at transitions of care phases. All variables were comparatively analyzed using regression analysis.
Results:
A total of 253 patients were included in this study, 129 as cases and 124 as controls. Presence of positive confusion assessment method (CAM) ICU was found to be statistically higher in the control population (p=0.013). All other risk factor variables were not statistically significant (p >0.05). The impact of pharmacist involvement at transitions of care phases was also not significant (p >0.05).
Conclusion:
Positive CAM ICU was statistically higher in patients who were not readmitted within 30 days following an initial sepsis and/or septic shock admission. All other risk factor variables were non-significant. We found that pharmacist transitions of care interventions did not reduce 30-day readmissions in the sepsis population. Clinical limitations including sample size and lack of disease severity stratification may impact these findings. Further research is needed to characterize in-hospital factors that contribute to increased sepsis readmissions, so that targeted interventions may occur.