Among sepsis survivors, readmissions due to infections occur sooner and are associated with increased mortality

BACKGROUND: Readmissions after sepsis hospitalisations are more likely to result in death compared to readmissions after non-sepsis hospitalisations. METHODS: Retrospective study of one hundred and forty-seven intensive care unit survivors of severe sepsis. Results: Over a median follow-up of 565 (200–953) days, 88 patients (59.8%) were readmitted, 40 with an infectious process (45.4%) and 48 with a non-infectious condition (54.5%). Median time to first rehospitalisation for the entire cohort was 89 (19–337) days; patients admitted with an infectious cause were readmitted sooner; 65.7 (11–201) days vs. 144 (52.3–383) days, P = 0.02. Most cases of infectious readmissions were due to pneumonia (17 patients, 42.5%), and urinary tract infections (UTI) (7 patients, 17.5%). Survival rate was 45% (18/40) in those readmitted with an infectious process vs. 70.8% (34/48) in those readmitted due to a non-infectious cause, P = 0.01. In multivariate analyses, age (HR 1.04 [95% CI: 1.01–1.08]; P = 0.002) and infectious cause of readmission (HR 2.0 [95% CI: 1.005–4]; P = 0.04) remained associated with increased mortality. CONCLUSIONS: Among sepsis survivors, infections are associated with shorter time to hospital readmission and higher mortality vs non-infectious causes. Most of the infectious readmissions were due to pneumonia or UTI, which mirrored the index hospitalisations.