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01-04-2020 | Septicemia | Systematic Review

Rate and risk factors for rehospitalisation in sepsis survivors: systematic review and meta-analysis

Authors: Manu Shankar-Hari, Rohit Saha, Julie Wilson, Hallie C. Prescott, David Harrison, Kathryn Rowan, Gordon D. Rubenfeld, Neill K. J. Adhikari

Published in: Intensive Care Medicine | Issue 4/2020

Abstract

Purpose

Sepsis survivors have a higher risk of rehospitalisation and of long-term mortality. We assessed the rate, diagnosis, and independent predictors for rehospitalisation in adult sepsis survivors.

Methods

We searched for non-randomized studies and randomized clinical trials in MEDLINE, Cochrane Library, Web of Science, and EMBASE (OVID interface, 1992–October 2019). The search strategy used controlled vocabulary terms and text words for sepsis and hospital readmission, limited to humans, and English language. Two authors independently selected studies and extracted data using predefined criteria and data extraction forms.

Results

The literature search identified 12,544 records. Among 56 studies (36 full and 20 conference abstracts) that met our inclusion criteria, all were non-randomised studies. Studies most often report 30-day rehospitalisation rate (mean 21.4%, 95% confidence interval [CI] 17.6–25.4%; N = 36 studies reporting 6,729,617 patients). The mean (95%CI) rehospitalisation rates increased from 9.3% (8.3–10.3%) by 7 days to 39.0% (22.0–59.4%) by 365 days. Infection was the most common rehospitalisation diagnosis. Risk factors that increased the rehospitalisation risk in sepsis survivors were generic characteristics such as older age, male, comorbidities, non-elective admissions, hospitalisation prior to index sepsis admission, and sepsis characteristics such as infection and illness severity, with hospital characteristics showing inconsistent associations. The overall certainty of evidence was moderate for rehospitalisation rates and low for risk factors.

Conclusions

Rehospitalisation events are common in sepsis survivors, with one in five rehospitalisation events occurring within 30 days of hospital discharge following an index sepsis admission. The generic and sepsis-specific characteristics at index sepsis admission are commonly reported risk factors for rehospitalisation.

Registration

PROSPERO CRD 42016039257, registered on 14-06-2016.

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Title: Rate and risk factors for rehospitalisation in sepsis survivors: systematic review and meta-analysis
Authors: Manu Shankar-Hari
Rohit Saha
Julie Wilson
Hallie C. Prescott
David Harrison
Kathryn Rowan
Gordon D. Rubenfeld
Neill K. J. Adhikari
Publication date: 01-04-2020
Publisher: Springer Berlin Heidelberg
Keywords: Septicemia
Septicemia
Published in: Intensive Care Medicine / Issue 4/2020
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-019-05908-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Rate and risk factors for rehospitalisation in sepsis survivors: systematic review and meta-analysis

Abstract

Purpose

Methods

Results

Conclusions

Registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Registration

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