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脓毒症幸存者中门诊护理敏感型疾病的再入院情况——一项利用2016 - 2019年医疗理赔数据的全国性队列研究

Rehospitalizations for ambulatory care sensitive conditions in sepsis survivors- a nationwide cohort study using health claims data 2016-2019.

作者信息

Wedekind Lisa, Rose Norman, Freytag Antje, Kimmig Aurelia, Schlattmann Peter, Pletz Mathias W, Ruhnke Thomas, Dröge Patrik, Fleischmann-Struzek Carolin

机构信息

Institute of Medical Statistics, Computer and Data Sciences, Jena University Hospital, Jena, Germany.

Institute of Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany.

出版信息

Infection. 2025 Jul 18. doi: 10.1007/s15010-025-02606-9.

Abstract

PURPOSE

Sepsis survivors suffer from frequent rehospitalizations, of which a certain proportion is considered preventable by timely and adequate management in the outpatient setting (= ambulatory care sensitive conditions, ACSC). We aimed to assess the frequency of and risk factors for ACSC and infection-associated ACSC rehospitalization among sepsis survivors.

METHODS

Population-based, retrospective cohort study among using nationwide health claims data of the "AOK- die Gesundheitskasse". Sepsis patients with inpatient treatment in 2016-2019 were identified using ICD-codes. Among sepsis hospital survivors, ACSC and infection-related ACSC were identified. Patient-related risk factors for ACSC were assessed by a multiple logistic regression analysis.

RESULTS

We included 347,826 sepsis patients and 234,874 sepsis hospital survivors. A total of 53.2% and 21.3% of sepsis survivors had at least one ACSC and infection-related ACSC rehospitalizations in the 12-months post-discharge, respectively. ACSC rehospitalizations often occurred closely after discharge and more frequently affected older, male, care dependent patients as well as those living in rural areas.

CONCLUSION

ACSC are common among sepsis survivors. This underlines to need for structured aftercare programs and interventions in these patients, particularly for ACSC risk groups which comprise older, male, care dependent patients in rural areas.

摘要

目的

脓毒症幸存者经常再次住院,其中一定比例被认为可通过门诊环境中的及时充分管理(即非卧床护理敏感情况,ACSC)来预防。我们旨在评估脓毒症幸存者中ACSC以及与感染相关的ACSC再次住院的频率和危险因素。

方法

利用“AOK健康保险公司”的全国健康索赔数据进行基于人群的回顾性队列研究。使用国际疾病分类代码识别2016 - 2019年接受住院治疗的脓毒症患者。在脓毒症住院幸存者中,识别出ACSC和与感染相关的ACSC。通过多元逻辑回归分析评估ACSC的患者相关危险因素。

结果

我们纳入了347,826例脓毒症患者和234,874例脓毒症住院幸存者。分别有53.2%和21.3%的脓毒症幸存者在出院后的12个月内至少有一次ACSC和与感染相关的ACSC再次住院。ACSC再次住院通常在出院后不久发生,并且更频繁地影响年龄较大、男性、需要护理的患者以及农村地区的患者。

结论

ACSC在脓毒症幸存者中很常见。这突出表明需要为这些患者制定结构化的后续护理计划和干预措施,特别是针对包括农村地区年龄较大、男性、需要护理的患者在内的ACSC风险群体。

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