{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T03:40:03Z","timestamp":1792381203602,"version":"4.4.0"},"reference-count":47,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T00:00:00Z","timestamp":1792281600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T00:00:00Z","timestamp":1792281600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000056","name":"National Institute of Nursing Research","doi-asserted-by":"publisher","award":["2R01NR016014"],"award-info":[{"award-number":["2R01NR016014"]}],"id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["1F99AG095132"],"award-info":[{"award-number":["1F99AG095132"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Older sepsis survivors face elevated rehospitalization risk shaped by multimorbidity and post\u2010sepsis vulnerability, yet traditional risk models evaluate these factors in isolation. To identify clinically meaningful profiles of coexisting rehospitalization risk factors among older sepsis survivors receiving home health care (HHC), we used clustering to characterize risk subgroups and examined their association with 30\u2010day rehospitalization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study of Medicare fee\u2010for\u2010service beneficiaries aged 65\u2009years or older who transitioned to HHC after hospitalization for sepsis between January 1, 2021 and December 31, 2022 in the United States. Partitioning around medoids clustering with Gower distance was used to identify risk clusters based on risk factors available during the index hospitalization and first post\u2010discharge HHC assessment. Multivariable logistic regression examined associations between cluster membership and all\u2010cause 30\u2010day rehospitalization, adjusting for contextual, HHC agency, and service delivery factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 21,888 index stays, two rehospitalization risk clusters were identified. Both clusters demonstrated post\u2010acute vulnerability after sepsis hospitalization but differed in intensity and breadth of impairments. The higher vulnerability cluster had greater functional dependency, cognitive and behavioral impairment, urinary and bowel incontinence, difficulty following medical instructions, and prior healthcare utilization. Compared with the lower post\u2010acute vulnerability cluster, the higher post\u2010acute vulnerability cluster had a higher 30\u2010day rehospitalization rate (27.8% vs. 21.1%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and significantly higher odds of 30\u2010day rehospitalization in unadjusted (OR 1.492; 95% CI 1.400\u20131.589;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and adjusted analyses (aOR 1.480; 95% CI 1.384\u20131.582;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among older sepsis survivors receiving HHC, rehospitalization risk clustered into two post\u2010acute vulnerability profiles that primarily reflected differences in the overall extent of multidimensional vulnerability. These profiles may help characterize co\u2010occurring post\u2010acute needs and support future evaluation of whether cluster\u2010informed care coordination or stratified post\u2010acute care can improve outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.70796","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T02:57:28Z","timestamp":1792378648000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond Sepsis Survival: Post\u2010Acute Vulnerability Profiles in Older Home Health Patients"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1424-4140","authenticated-orcid":false,"given":"Sang Bin","family":"You","sequence":"first","affiliation":[{"name":"University of Pennsylvania School of Nursing  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiyoun","family":"Song","sequence":"additional","affiliation":[{"name":"University of Pennsylvania School of Nursing  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Ryvicker","sequence":"additional","affiliation":[{"name":"Center for Home Care Policy &amp; Research VNS Health  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yolanda","family":"Barr\u00f3n","sequence":"additional","affiliation":[{"name":"Center for Home Care Policy &amp; Research VNS Health  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Quinn","sequence":"additional","affiliation":[{"name":"University of Pennsylvania School of Nursing  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse Y.","family":"Hsu","sequence":"additional","affiliation":[{"name":"University of Pennsylvania Perelman School of Medicine  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9287-153X","authenticated-orcid":false,"given":"Mary D.","family":"Naylor","sequence":"additional","affiliation":[{"name":"University of Pennsylvania School of Nursing  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen B.","family":"Lasater","sequence":"additional","affiliation":[{"name":"University of Pennsylvania School of Nursing  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn H.","family":"Bowles","sequence":"additional","affiliation":[{"name":"University of Pennsylvania School of Nursing  Philadelphia Pennsylvania USA"},{"name":"Center for Home Care Policy &amp; 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