Mortality Following 30-Day Readmission With Sepsis: An Analysis of U.S. Readmission Data

Abstract Background: Sepsis is a leading cause of in-hospital mortality. Post-discharge outcomes, particularly 30-day readmissions, are critical to understanding and reducing preventable sepsis-related deaths. Objective: To identify factors associated with sepsis-related mortality following 30-day readmission. Design, Setting, and Participants: A retrospective cohort study utilizing 2021 Healthcare Cost and Utilization Project (HCUP) Nationwide Readmissions Database. Patients readmitted within 30 days with an ICD-10 diagnosis of sepsis were included. Main Outcomes and Measures: In-hospital mortality following 30-day readmission. Multivariate logistic regression identified factors associated with mortality. Results: Among 1,316,952 patients, 64,056 (4.9%) died following readmission. Among those that died, 31,203 had a diagnosis of sepsis (48.7%). Mean age of decedents was 71.26 years (SD 14.04). Factors significantly associated with increased mortality included same-day readmission (aOR 3.38 [95% CI, 3.17–3.60]), elective admission (aOR 2.20 [95% CI, 2.08–2.33]), major operating room procedures (aOR 2.06 [95% CI, 1.999–2.12]), lack of transfer to post-acute care (aOR 1.95 [95% CI, 1.81–2.10]), female biological sex (aOR 1.17 [95% CI, 1.15–1.19]), non-metropolitan residence (aOR 1.31 [95% CI, 1.27–1.41]), and lowest income quartile (aOR 1.13 [95% CI, 1.10–1.16]). Conclusions and Relevance: Targeted strategies to address discharge planning, rural health disparities, and socioeconomic barriers are needed to reduce sepsis-related mortality following readmission.