The Southern Medical Journal (SMJ) is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists.

SMJ // Article

Original Article

Decreasing 72-Hour Readmission Rates Among Patients with Sepsis

Authors: Rowan Burns, BS, Liela Meng, MS, Mirinda Ann Gormley, PhD, MSPH, Stella Self, PhD, MS, Nathan Hudepohl, MD

Abstract

Objectives: Sepsis survivors are susceptible to health complications, substantially increasing the risk of emergency department (ED) and hospital readmissions. Few evaluations, however, have assessed the effectiveness of interventions targeted at decreasing readmissions among patients with sepsis. This study evaluated the effectiveness of a targeted intervention to decrease 72-hour ED readmission rates in patients with sepsis or pyelonephritis in a large ED in the US South.

Methods: This retrospective cohort study investigated 72-hour readmission rates from January 1, 2020 to December 31, 2023 for adults with an ED diagnosis of sepsis or pyelonephritis. An intervention to decrease ED readmissions was implemented on May 4, 2021. Monthly readmission rates were calculated as the proportion of patients readmitted within 72 hours of discharge following an ED visit with a discharge diagnosis of sepsis or pyelonephritis. Interrupted time series analysis was used to assess the differences in trends of monthly readmission rates prepolicy implementation, during policy implementation, and postpolicy implementation.

Results: Of 39,818 patients, 4907 (12.3%) had 72-hour readmissions. Preintervention, 72-hour readmissions increased by 0.00054 per admission per month (P = 0.30). At implementation, there was an immediate drop of 0.0017 in the monthly readmission rate (P = 0.75), and in postimplementation period, the trend reversed, with a sustained decrease of 0.00112 readmissions per admission per month (P = 0.04). There were sustained decreases in readmissions per admission per month of 0.00061 (P = 0.25) and 0.0033 (P = 0.02) for pyelonephritis and sepsis, respectively.

Conclusions: This intervention was associated with a sustained decrease in readmissions per month for septic individuals seen in the ED.

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