{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T08:35:07Z","timestamp":1789979707596,"version":"4.0.1"},"reference-count":24,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2015,7,20]],"date-time":"2015-07-20T00:00:00Z","timestamp":1437350400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Cubist Pharmaceuticals, Lexington, Massachusetts"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Hospital Medicine"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>With decreasing mortality in sepsis, attention has shifted to longer\u2010term consequences associated with survivorship. Thirty\u2010day readmission as a component of healthcare utilization is an important outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>To examine the frequency of and risk factors for 30\u2010day readmission among patients surviving sepsis.<\/jats:p><\/jats:sec><jats:sec><jats:title>DESIGN<\/jats:title><jats:p>Single\u2010center retrospective cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS\/SETTING<\/jats:title><jats:p>We examined 30\u2010day readmission risk among survivors of hospitalization with culture\u2010positive severe sepsis or septic shock. Extended spectrum \u03b2\u2010lactamase (ESBL) organisms were identified via molecular laboratory testing. Healthcare\u2010associated (HCA) was defined by 1 of the following: (1) recent hospitalization, (2) immune suppression, (3) nursing home residence, (4) hemodialysis, (5) prior antibiotics, and (6) index bacteremia hospital\u2010acquired (onset &gt;2 days following admission). Acute kidney injury (AKI) was defined according to the RIFLE (Risk, Injury, Failure, Loss, End\u2010stage) criteria. Logistic regression modeled predictors of 30\u2010day readmission.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Among 1697 sepsis survivors, 543 (32.0%) required 30\u2010day readmission. Readmitted patients had a higher chronic (median Charlson score 5 vs 4, <jats:italic>P<\/jats:italic> &lt; 0.001) but not acute (median APACHE [Acute Physiology and Chronic Health Evaluation] II score 15 and 15, <jats:italic>P<\/jats:italic> = 0.275) illness burden, and higher prevalence of HCA sepsis (94.2% vs 90.2%, <jats:italic>P<\/jats:italic> = 0.014) than nonreadmitted survivors. In logistic regression, 3 factors increased (Organism: ESBL [odds ratio {OR}: 4.50, 95% confidence interval {CI}: 1.43\u201314.19], RIFLE: Injury or RIFLE: Failure [OR: 1.95, 95% CI: 1.300\u20132.93], and Organism: <jats:italic>Bacteroides<\/jats:italic> spp [OR: 2.04, 95% CI: 1.06\u20133.95]) and 2 reduced (Source: Urine [OR: 0.58, 95% CI: 0.35\u20130.98], Organism: <jats:italic>Escherichia coli<\/jats:italic> [OR: 0.49, 95% CI: 0.27\u20130.90]) the odds of 30\u2010day readmission.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>One\u2010third of survivors of severe sepsis\/septic shock required 30\u2010day readmission. Mild\u2010to\u2010moderate AKI nearly doubled its risk. <jats:italic>Journal of Hospital Medicine<\/jats:italic> 2015;10:678\u2013685. \u00a9 2015 Society of Hospital Medicine<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhm.2420","type":"journal-article","created":{"date-parts":[[2015,7,20]],"date-time":"2015-07-20T09:19:47Z","timestamp":1437383987000},"page":"678-685","source":"Crossref","is-referenced-by-count":19,"title":["Risk factors for 30\u2010day readmission among patients with culture\u2010positive severe sepsis and septic shock: A retrospective cohort study"],"prefix":"10.1002","volume":"10","author":[{"given":"Marya D.","family":"Zilberberg","sequence":"first","affiliation":[{"name":"Department of Health Services Research EviMed Research Group, LLC Goshen Massachusetts"},{"name":"University of Massachusetts Amherst Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew F.","family":"Shorr","sequence":"additional","affiliation":[{"name":"Department of Medicine Washington Hospital Center Washington DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott T.","family":"Micek","sequence":"additional","affiliation":[{"name":"Department of Pharmacy St. Louis College of Pharmacy St. Louis Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marin H.","family":"Kollef","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Pulmonary and Critical Care Medicine Washington University School of Medicine St. Louis Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,7,20]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000194725.48928.3A"},{"key":"e_1_2_6_3_1","first-page":"1","article-title":"Death in the United States, 2007","volume":"26","author":"Minino AM","year":"2009","journal-title":"NCHS Data Brief."},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa022139"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200107000-00002"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e318232db65"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000186748.64438.7B"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000261890.41311.E9"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000000026"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2014.1608"},{"key":"e_1_2_6_11_1","unstructured":"SuttonJ FriedmanB.Trends in septicemia hospitalizations and readmissions in selected HCUP states 2005 and 2010. HCUP Statistical Brief #161. Agency for Healthcare Research and Quality Rockville MD. Available at:http:\/\/www.hcup\u2010us.ahrq.gov\/reports\/statbriefs\/sb161.pdf. 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