Among sepsis survivors, readmissions due to infections occur sooner and are associated with increased mortality

Background
Readmissions after sepsis hospitalisations are more likely to result in death compared to readmissions after non-sepsis hospitalisations.

Material and methods
Retrospective study of one hundred and forty-seven intensive care unit survivors of severe sepsis.

Results
Over a median follow-up of 565 (200–953) days, 88 patients (59.8%) were readmitted, 40 with an infectious process (45.4%) and 48 with a non-infectious condition (54.5%). Median time to first rehospitalisation for the entire cohort was 89 (19–337) days; patients admitted with an infectious cause were readmitted sooner; 65.7 (11–201) days vs. 144 (52.3–383) days, P = 0.02. Most cases of infectious readmissions were due to pneumonia (17 patients, 42.5%), and urinary tract infections (UTI) (7 patients, 17.5%). Survival rate was 45% (18/40) in those readmitted with an infectious process vs. 70.8% (34/48) in those readmitted due to a non-infectious cause, P = 0.01. In multivariate analyses, age (HR 1.04 [95% CI: 1.01–1.08]; P = 0.002) and infectious cause of readmission (HR 2.0 [95% CI: 1.005–4]; P = 0.04) remained associated with increased mortality.

Conclusions
Among sepsis survivors, infections are associated with shorter time to hospital readmission and higher mortality vs non-infectious causes. Most of the infectious readmissions were due to pneumonia or UTI, which mirrored the index hospitalisations.