{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T22:11:33Z","timestamp":1790892693983,"version":"4.1.0"},"reference-count":58,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100012456","name":"National Social Science Fund of China","doi-asserted-by":"publisher","award":["21BSH120"],"award-info":[{"award-number":["21BSH120"]}],"id":[{"id":"10.13039\/501100012456","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sepsis is a critical global health issue, particularly affecting older adults. Despite advances in acute sepsis management, the long\u2010term outcomes for survivors, particularly those transitioning to skilled nursing facilities (SNFs), remain poorly characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate the prognostic value of the age\u2010adjusted Charlson Comorbidity Index (ACCI) in predicting 6\u2010month mortality among older adult sepsis survivors discharged to SNFs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>An observational cohort study of older adult sepsis patients in the intensive care unit (ICU) of a tertiary academic medical centre in Boston from 2008 to 2019 was performed. Patients were stratified into low (\u2264\u20095), intermediate (6, 7) and high (\u2265\u20098) ACCI score groups. Using the Cox proportional hazards model, we determined the association between ACCI scores and 6\u2010month mortality, calculating hazard ratios (HR) and 95% confidence intervals (CIs). The predictive performance was assessed using ROC curve analysis and compared with Sequential Organ Failure Assessment (SOFA) scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study included 3713 sepsis survivors aged 65 and older discharged to SNFs. The median age was around 80\u2009years, and 52.6% of the participants were female. The analysis revealed that each one\u2010point increase in the ACCI was associated with an 18% higher risk of mortality within 6\u2009months (HR 1.18; 95% CI 1.14\u20131.22;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Furthermore, compared with individuals with low ACCI scores, those in the moderate ACCI score group had a HR of 1.55 (95% CI: 1.26\u20131.91,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and those in the high ACCI score group had a HR of 2.43 (95% CI: 1.96\u20133.03,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). ACCI demonstrated superior predictive performance compared with SOFA scores (area under the curve [AUC] 0.65 vs. 0.53,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ACCI serves as an independent predictor of 6\u2010month mortality in older adult sepsis survivors discharged to SNFs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>Critical care nurses can use ACCI as a risk stratification tool to identify high\u2010risk older sepsis survivors, inform discharge planning and improve interprofessional communication for tailored post\u2010acute care interventions in SNFs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.70078","type":"journal-article","created":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T21:30:26Z","timestamp":1748813426000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Older Adult Sepsis Survivors Discharged to Skilled Nursing Facilities: Age\u2010Adjusted Charlson Comorbidity Index as a Predictor of 6\u2010Month Mortality"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3739-9097","authenticated-orcid":false,"given":"Hongtao","family":"Cheng","sequence":"first","affiliation":[{"name":"School of Nursing Sun Yat\u2010Sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4973-2291","authenticated-orcid":false,"given":"Lu","family":"Shao","sequence":"additional","affiliation":[{"name":"School of Nursing Sun Yat\u2010Sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huijun","family":"Wu","sequence":"additional","affiliation":[{"name":"School of Nursing Sun Yat\u2010Sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boya","family":"Mi","sequence":"additional","affiliation":[{"name":"School of Nursing Sun Yat\u2010Sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiugui","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Intensive Care Unit, Xiangyang Central Hospital Affiliated Hospital of Hubei University of Arts and Science  Xiangyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6599-702X","authenticated-orcid":false,"given":"June","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Nursing Sun Yat\u2010Sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,1]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0287"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)32989-7"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-023-01233-7"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200107000-00002"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000261890.41311.E9"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000194535.82812.BA"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-023-01160-7"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002872"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-020-06151-x"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31827c09f8"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181d8cc1d"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.167"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1301372"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.1553"},{"key":"e_1_2_13_16_1","article-title":"Late Mortality After Sepsis: Propensity Matched Cohort Study","volume":"353","author":"Prescott H. 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