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One-year hospital readmission for recurrent sepsis: associated risk factors and impact on 1-year mortality—a French nationwide study

BACKGROUND: Sepsis is a complex health condition, leading to long-term morbidity and mortality. Understanding the risk factors for recurrent sepsis, as well as its impact on mid- and long-term mortality among other risk factors, is essential to improve patient survival. METHODS: A risk factor analys...

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Autores principales: Pandolfi, Fanny, Brun-Buisson, Christian, Guillemot, Didier, Watier, Laurence
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9710072/
https://www.ncbi.nlm.nih.gov/pubmed/36447252
http://dx.doi.org/10.1186/s13054-022-04212-9
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author Pandolfi, Fanny
Brun-Buisson, Christian
Guillemot, Didier
Watier, Laurence
author_facet Pandolfi, Fanny
Brun-Buisson, Christian
Guillemot, Didier
Watier, Laurence
author_sort Pandolfi, Fanny
collection PubMed
description BACKGROUND: Sepsis is a complex health condition, leading to long-term morbidity and mortality. Understanding the risk factors for recurrent sepsis, as well as its impact on mid- and long-term mortality among other risk factors, is essential to improve patient survival. METHODS: A risk factor analysis, based on French nationwide medico-administrative data, was conducted on a cohort of patients above 15 years old, hospitalized with an incident sepsis in metropolitan France between 1st January 2018 and 31st December 2018 and who survived their index hospitalization. Two main analyses, focusing on outcomes occurring 1-year post-discharge, were conducted: a first one to assess risk factors for recurrent sepsis and a second to assess risk factors for mortality. RESULTS: Of the 178017 patients surviving an incident sepsis episode in 2018 and included in this study, 22.3% died during the 1-year period from discharge and 73.8% had at least one hospital readmission in acute care, among which 18.1% were associated with recurrent sepsis. Patients aged between 56 and 75, patients with cancer and renal disease, with a long index hospital stay or with mediastinal or cardiac infection had the highest odds of recurrent sepsis. One-year mortality was higher for patients with hospital readmission for recurrent sepsis (aOR 2.93; 99% CI 2.78–3.09). Among all comorbidities, patients with cancer (aOR 4.35; 99% CI 4.19–4.52) and dementia (aOR 2.02; 99% CI 1.90–2.15) had the highest odds of 1-year mortality. CONCLUSION: Hospital readmission for recurrent sepsis is one of the most important risk factors for 1-year mortality of septic patients, along with age and comorbidities. Our study suggests that recurrent sepsis, as well as modifiable or non-modifiable other risk factors identified, should be considered in order to improve patient care pathway and survival. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13054-022-04212-9.
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spelling pubmed-97100722022-12-01 One-year hospital readmission for recurrent sepsis: associated risk factors and impact on 1-year mortality—a French nationwide study Pandolfi, Fanny Brun-Buisson, Christian Guillemot, Didier Watier, Laurence Crit Care Research BACKGROUND: Sepsis is a complex health condition, leading to long-term morbidity and mortality. Understanding the risk factors for recurrent sepsis, as well as its impact on mid- and long-term mortality among other risk factors, is essential to improve patient survival. METHODS: A risk factor analysis, based on French nationwide medico-administrative data, was conducted on a cohort of patients above 15 years old, hospitalized with an incident sepsis in metropolitan France between 1st January 2018 and 31st December 2018 and who survived their index hospitalization. Two main analyses, focusing on outcomes occurring 1-year post-discharge, were conducted: a first one to assess risk factors for recurrent sepsis and a second to assess risk factors for mortality. RESULTS: Of the 178017 patients surviving an incident sepsis episode in 2018 and included in this study, 22.3% died during the 1-year period from discharge and 73.8% had at least one hospital readmission in acute care, among which 18.1% were associated with recurrent sepsis. Patients aged between 56 and 75, patients with cancer and renal disease, with a long index hospital stay or with mediastinal or cardiac infection had the highest odds of recurrent sepsis. One-year mortality was higher for patients with hospital readmission for recurrent sepsis (aOR 2.93; 99% CI 2.78–3.09). Among all comorbidities, patients with cancer (aOR 4.35; 99% CI 4.19–4.52) and dementia (aOR 2.02; 99% CI 1.90–2.15) had the highest odds of 1-year mortality. CONCLUSION: Hospital readmission for recurrent sepsis is one of the most important risk factors for 1-year mortality of septic patients, along with age and comorbidities. Our study suggests that recurrent sepsis, as well as modifiable or non-modifiable other risk factors identified, should be considered in order to improve patient care pathway and survival. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13054-022-04212-9. BioMed Central 2022-11-29 /pmc/articles/PMC9710072/ /pubmed/36447252 http://dx.doi.org/10.1186/s13054-022-04212-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Pandolfi, Fanny
Brun-Buisson, Christian
Guillemot, Didier
Watier, Laurence
One-year hospital readmission for recurrent sepsis: associated risk factors and impact on 1-year mortality—a French nationwide study
title One-year hospital readmission for recurrent sepsis: associated risk factors and impact on 1-year mortality—a French nationwide study
title_full One-year hospital readmission for recurrent sepsis: associated risk factors and impact on 1-year mortality—a French nationwide study
title_fullStr One-year hospital readmission for recurrent sepsis: associated risk factors and impact on 1-year mortality—a French nationwide study
title_full_unstemmed One-year hospital readmission for recurrent sepsis: associated risk factors and impact on 1-year mortality—a French nationwide study
title_short One-year hospital readmission for recurrent sepsis: associated risk factors and impact on 1-year mortality—a French nationwide study
title_sort one-year hospital readmission for recurrent sepsis: associated risk factors and impact on 1-year mortality—a french nationwide study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9710072/
https://www.ncbi.nlm.nih.gov/pubmed/36447252
http://dx.doi.org/10.1186/s13054-022-04212-9
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