医学
败血症
逻辑回归
置信区间
急诊医学
回顾性队列研究
急诊科
观察研究
优势比
感染性休克
接收机工作特性
内科学
精神科
作者
Hannah Dashefsky,Hongyan Liu,Katie Hayes,Heather Griffis,Melissa Vaughan,Marianne Chilutti,Fran Balamuth,Hannah Stinson,Julie C. Fitzgerald,Erin Carlton,Scott L. Weiss
出处
期刊:Pediatrics
[American Academy of Pediatrics]
日期:2023-06-27
卷期号:152 (1)
被引量:2
标识
DOI:10.1542/peds.2022-060819
摘要
OBJECTIVES Although children who survive sepsis are at risk for readmission, identification of patient-level variables associated with readmission has been limited by administrative datasets. We determined frequency and cause of readmission within 90 days of discharge and identified patient-level variables associated with readmission using a large, electronic health record-based registry. METHODS This retrospective observational study included 3464 patients treated for sepsis or septic shock between January 2011 and December 2018 who survived to discharge at a single academic children’s hospital. We determined frequency and cause of readmission through 90 days post-discharge and identified patient-level variables associated with readmission. Readmission was defined as inpatient treatment within 90 days post-discharge from a prior sepsis hospitalization. Outcomes were frequency of and reasons for 7-, 30-, and 90-day (primary) readmission. Patient variables were tested for independent associations with readmission using multivariable logistic regression. RESULTS Following index sepsis hospitalization, frequency of readmission at 7, 30, and 90 days was 7% (95% confidence interval 6%–8%), 20% (18%–21%), and 33% (31%–34%). Variables independently associated with 90-day readmission were age ≤ 1 year, chronic comorbid conditions, lower hemoglobin and higher blood urea nitrogen at sepsis recognition, and persistently low white blood cell count ≤ 2 thous/µL. These variables explained only a small proportion of overall risk (pseudo-R2 range 0.05–0.13) and had moderate predictive validity (area under the receiver operating curve range 0.67–0.72) for readmission. CONCLUSIONS Children who survive sepsis were frequently readmitted, most often for infections. Risk for readmission was only partly indicated by patient-level variables.
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