干旱区生态环境知识资源中心(Arid): Sepsis Survivors Transitioned to Home Health Care: Characteristics and Early Readmission Risk Factors

Arid

DOI	10.1016/j.jamda.2019.11.001
	Sepsis Survivors Transitioned to Home Health Care: Characteristics and Early Readmission Risk Factors
	Bowles, Kathryn H.1,2; Murtaugh, Christopher M.2; Jordan, Lizeyka 2; Barron, Yolanda 2; Mikkelsen, Mark E.3; Whitehouse, Christina R.4; Chase, Jo-Ana D.5; Ryvicker, Miriam 2; Feldman, Penny Hollander 2
通讯作者	Bowles, Kathryn H.
来源期刊	JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
ISSN	1525-8610
EISSN	1538-9375
出版年	2020
卷号	21 期号:1 页码:84-+
英文摘要	Objective: To profile the characteristics of growing numbers of sepsis survivors receiving home healthcare (HHC) by type of sepsis before, during, and after a sepsis hospitalization and identify characteristics significantly associated with 7-day readmission. Design: Cross-sectional descriptive study. Data sources included the Outcome and Assessment Information Set (OASIS) and Medicare administrative and claims data. Setting and Participants: National sample of Medicare beneficiaries hospitalized for sepsis who were discharged to HHC between July 1, 2013 and June 30, 2014 (N = 165,228). Methods: We used an indicator distinguishing among 3 types of sepsis: explicitly coded sepsis diagnosis without organ dysfunction; severe sepsis with organ dysfunction; and septic shock. We compared these subgroups' demographic, clinical and functional characteristics, comorbidities, risk factors for rehospitalization, characteristics of the index hospital stay, and predicted 7-day hospital readmission. Results: The majority (80.7%) had severe sepsis, 5.7% had septic shock, and 13.6% had sepsis without acute organ system dysfunction. The medical diagnoses recorded at HHC admission identified sepsis or blood infection only 7% of the time, potentially creating difficulty identifying the sepsis survivor in HHC. Among sepsis types, septic shock survivors had the greatest illness burden profile. This study describes 12 key variables, each of which individually raises the relative 7-day readmission risk by as much as 60%. Increased risk of 7-day rehospitalization was found among those with septic shock, 3 or more previous inpatient stays, index hospital length of stay of >8 days, dyspnea, >6 functional dependencies, and other risk factors. Conclusions and Implications: Implications for practice include using our findings to identify sepsis survivors who are at risk for early readmission. Assessment for these factors may profile the at-risk patient, thereby triggering the call for additional acute care intervention such as delayed discharge, or post-acute intervention such as early home visit and outpatient follow-up. (C) 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
英文关键词	Sepsis transitional care hospital discharge home healthcare readmission
类型	Article
语种	英语
国家	USA
开放获取类型	Green Accepted
收录类别	SCI-E ; SSCI
WOS记录号	WOS:000504685400015
WOS关键词	HOSPITAL READMISSION ; EPIDEMIOLOGY ; PREDICTORS ; VALIDITY ; OASIS ; CODES ; COST
WOS类目	Geriatrics & Gerontology
WOS研究方向	Geriatrics & Gerontology
EI主题词	2020-01-01
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/312080
作者单位	1.Univ Penn, Sch Nursing, 418 Curie Blvd, Philadelphia, PA 19146 USA; 2.Visiting Nurse Serv New York, Ctr Home Care Policy & Res, New York, NY USA; 3.Univ Penn, Perelman Sch Med, Philadelphia, PA 19104 USA; 4.M Louise Fitzpatrick Coll Nursing, Driscoll Hall, Villanova, PA USA; 5.Univ Missouri, Sinclair Sch Nursing, Columbia, MO USA
推荐引用方式 GB/T 7714	Bowles, Kathryn H.,Murtaugh, Christopher M.,Jordan, Lizeyka,et al. Sepsis Survivors Transitioned to Home Health Care: Characteristics and Early Readmission Risk Factors[J],2020,21(1):84-+.
APA	Bowles, Kathryn H..,Murtaugh, Christopher M..,Jordan, Lizeyka.,Barron, Yolanda.,Mikkelsen, Mark E..,...&Feldman, Penny Hollander.(2020).Sepsis Survivors Transitioned to Home Health Care: Characteristics and Early Readmission Risk Factors.JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION,21(1),84-+.
MLA	Bowles, Kathryn H.,et al."Sepsis Survivors Transitioned to Home Health Care: Characteristics and Early Readmission Risk Factors".JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION 21.1(2020):84-+.