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- W2891478664 abstract "This study aimed to determine the rate and risk factors of same pathogen sepsis readmissions following previous hospitalization for septic shock. This retrospective study was performed using data from a prospective septic shock registry. This study was performed at a single urban tertiary center. All patients were treated with a protocol-driven resuscitation bundle therapy between 2011 and 2016. Adult (≥ 18 years) patients who were readmitted with sepsis within 90 days of discharge following hospitalization for septic shock. We analyzed 2062 septic shock patients, of whom 690 were readmitted within 90 days of discharge. Excluding scheduled and non-sepsis admissions, 274(13.3%) patients readmitted for sepsis were included. The culture-negative rate was 35.4% (97/274), while the same pathogen was isolated in 25% of cases (69/274). Multivariate analysis revealed that previous Gram-negative bacteremia, urinary tract infection, and same site infections were significantly associated with readmission for sepsis caused by the same pathogen. Instances of patient readmissions within 90 days of initial hospitalization for septic shock were not uncommon, comprising 13.3% of all readmissions, and the rate of isolation of the same pathogen was 25% among these cases. Most of the readmissions following septic shock were new infections rather than relapses of the initial infection. Clinicians may consider using the same antibiotics as those initially used for patients with the risk factors listed above.Table 1Characteristics of Patients with Recurrent SepsisCharacteristicsSepsis due to a different organism (N=205)Sepsis due to the same organism (N=69)p-valueAge65 (58-72)64 (56-72)0.658Male130 (63.1)31 (44.9)0.008Hypertension68 (33.0)31 (44.9)0.008Stroke22 (10.7)2 (2.9)0.074Diabetes57 (27.7)19 (27.5)0.983Coronary artery disease30 (14.6)5 (7.2)0.114Chronicpulmonary disease50 (24.3)13 (18.8)0.353Chronicrenal failure12 (5.8)7 (10.1)0.221Liver cirrhosis33 (16.0)18 (26.1)0.063Malignancy165 (80.1)58 (84.1)0.46728-day mortality5 (2.4)1 (1.4)0.63090-day mortality11 (5.3)5 (7.2)0.558Mechanical ventilation12 (5.8)2 (2.9)0.338Same site135 (65.5)62 (89.9)<0.001ICU, intensive care unit Open table in a new tab Table 2Characteristics of Causal OrganismsCharacteristicsTotal(%) N=274Different organism(%) N=205Same organism(%) N=69P-valueOrganismGram-positive34 (12.4)32 (15.5)2 (2.9)0.006Gram-negative181 (65.8)115 (55.8)66 (95.7)<0.001Viral13 (4.7)13 (6.3)0 (0)0.033Fungi4 (1.5)3 (1.5)1 (1.4)0.997SiteUrinary47 (17.1)23 (11.2)24 (34.8)<0.001Gastrointestinal146 (53.1)105 (51.0)41 (59.4)0.224Respiratory73 (26.5)70 (34.0)3 (4.3)<0.001Skin and soft tissue10 (3.6)8 (3.9)2 (2.9)0.705Other29 (10.5)23 (11.2)6 (8.7)0.563 Open table in a new tab Table 3Multivariate Analysis for Same Organism Reinfection in Study PatientsVariablesOR95% CIP-valueMale0.5890.295-1.1760.133Same site6.8942.390-19.886<0.001Gram-positive0.1940.037-1.0160.052Gram-negative9.9022.843-32.489<0.001UTI4.3311.723-10.8820.002Respiratory0.3120.086-1.1330.077OR, odds ratio; CI, confidence interval; UTI, urinary tract infection Open table in a new tab" @default.
- W2891478664 created "2018-09-27" @default.
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- W2891478664 date "2018-10-01" @default.
- W2891478664 modified "2023-09-26" @default.
- W2891478664 title "144 Risk Factors for Same Pathogen Sepsis Readmissions Following Hospitalization for Septic Shock" @default.
- W2891478664 doi "https://doi.org/10.1016/j.annemergmed.2018.08.149" @default.
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