Goodwin Andrew J, Ford Dee W
Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Medical University of South Carolina.
Clin Pulm Med. 2018 May;25(3):79-83. doi: 10.1097/CPM.0000000000000254.
Hospital readmissions are common and result in increased mortality and cost while reducing quality of life. Readmission rates have been subjected to increasing scrutiny in recent years as part of a larger effort to improve the quality and value of healthcare in the United States. Emerging evidence suggests that sepsis survivors are at high risk for hospital readmission and experience readmission rates comparable to survivors of congestive heart failure, acute myocardial infarction, pneumonia, and chronic obstructive pulmonary disease, diseases whose readmission rates determine reimbursement penalties from the federal government. In this article, we review the unique challenges that sepsis survivors face as well as the patient-level and hospital-level risk factors that are known to be associated with hospital readmission after sepsis survival. Additionally, we identify the causes and outcomes of readmissions in this population before concluding with a discussion of readmission prevention strategies and future directions.
医院再入院情况很常见,会导致死亡率上升、成本增加,同时降低生活质量。近年来,作为提高美国医疗质量和价值的更大努力的一部分,再入院率受到了越来越多的审查。新出现的证据表明,脓毒症幸存者再次入院的风险很高,其再入院率与充血性心力衰竭、急性心肌梗死、肺炎和慢性阻塞性肺疾病的幸存者相当,这些疾病的再入院率决定了联邦政府的报销处罚。在本文中,我们回顾了脓毒症幸存者面临的独特挑战,以及已知与脓毒症存活后医院再入院相关的患者层面和医院层面的风险因素。此外,在讨论再入院预防策略和未来方向之前,我们确定了该人群再入院的原因和后果。