About 16.4% of patients released from the hospital after a sepsis infection will be readmitted for sepsis treatment within one year (J Crit Care 2025;85:154925).
Patterns identified among sepsis survivors readmitted to the hospital lay the groundwork for improving outcomes in these patients. However, more research into clinical practice changes to reduce hospital readmission is needed, according to the researchers.
“Overall, this research highlights the specific diagnoses that adult and pediatric sepsis survivors are more likely to have when returning to hospital. [This] empowers clinicians to be vigilant for these conditions and manage care appropriately, minimizing rehospitalization risk. Additionally, our research paves the way for developing interventions focused on managing readmissions in sepsis survivors,” explained Khalia Ackermann, MPH, a PhD candidate with the Australian Institute of Health Innovation at Macquarie University, in Sydney.
Researchers found that 1 in 21 sepsis survivors return to the hospital with a sepsis infection within 30 days of discharge; this figure rises to 1 in 12, at 90 days after discharge. Furthermore, 1 in 59 sepsis survivors return to the hospital with pneumonia within 30 days, rising to 1 in 38 by 90 days. Lastly, 1 in 125 sepsis survivors returned to the hospital with a urinary tract infection within 30 days, rising to 1 in 59 by 90 days.
Infections were not the only concern among patients readmitted to the hospital; 1 in 29 sepsis survivors returned to the hospital within 30 days of discharge because of cardiovascular disease, and 1 in 67 returned with heart failure, leading Ms. Ackermann to conclude that “clinicians and survivors should also be vigilant for potential cardiovascular disease concerns” after recovering from sepsis.
The researchers conducted a meta-analysis of 51 studies of sepsis survivors readmitted to a hospital. Most (46/51) studied adults, and all were published after 2011. Only five studies analyzed hospital readmission for children with sepsis. Ms. Ackermann noted that infants and children younger than 5 years of age make up a large proportion (about 40%) of the global sepsis burden. The studies of juvenile readmission to hospitals after sepsis found that the reasons survivors returned to the hospital were diverse, with respiratory difficulties, infection, and oncologic or chemotherapy-related diagnoses reported most commonly. Children can have different sepsis presentations and disease courses compared with adults, so results taken from studies of adults may not translate well to children, she explained.
Considering the Long Term
Researching sepsis readmissions may necessitate a change among doctors because it will require them to look at outcomes for patients beyond hospitalization, according to Laura Evans, MD, the director of critical care at the University of Washington Medical Center, in Seattle, and a member of the committee who drafted the 2021 Surviving Sepsis Campaign guidelines.
However, she said Ms. Ackermann’s study is hypothesis-generating rather than practice-changing. “It poses important questions like: ‘Should we change the discharge instructions for patients, and what things need to be monitored in a sepsis patient when they are discharged?” said Dr. Evans, who is also serving on the committee updating the guidelines. These types of questions may be addressed in the next update.
Ms. Ackerman and Dr. Evans reported no relevant financial disclosures.
This article is from the April 2025 print issue.