Reducing hospital readmission is a national priority for facilitating recovery and reducing preventable morbidity and mortality after a hospital discharge. Risk factors for hospital readmission in general adult populations have been identified, but the relationship between the initial cause of hospitalization, or index hospitalization, and subsequent outcomes for readmitted patients remains unknown. To identify risk factors present during the index hospitalization that are associated with the outcomes of death or transitions to hospice care during later hospital readmission, researchers studied data from 30-day readmissions in an academic health system. They also examined the contribution of infection in readmissions resulting in death. The analysis identified sepsis and shock during index hospitalization as risk factors largely associated with in-hospital death or transition to hospice during subsequent readmission. Also, infection was frequently implicated as the cause of a readmission that ended in death. The study’s findings can be used to identify and target at-risk patients who have been treated for sepsis and other risk factors during the index hospitalization. Better characterization of patients at high risk of specific readmission outcomes is critical to developing targeted interventions at the time of index hospitalization.
Dietz BW, Jones TK, Small DS, Gaieski DF, Mikkelsen ME. The Relationship Between Index Hospitalizations, Sepsis, and Death or Transition to Hospice Care During 30-Day Hospital Readmissions. Med Care. 2017 Apr;55(4):362-370. PMID: 27820595