The following is a summary of “Prediction of Readmission Following Sepsis Using Social Determinants of Health,” published in the June 2024 issue of Critical Care by Amrollahi et al.
Researchers conducted a retrospective study comparing the effectiveness of social determinants of health (SDoH) variables against traditional clinical factors in predicting 30-day readmission after sepsis hospitalization.
They collected patient-level data from 35 hospitals across the United States (2017 to 2021). The data, originating from the AllofUs Research Program, included 271,428 individuals, of whom 8,909 patients had a prior hospitalization due to sepsis.
The result showed 8,909 patients with sepsis; 21% had an unplanned hospital readmission within 30 days. The median age was 54 (with an IQR of 41–65 years), and 53.4% were female. Racially, the study consisted of individuals with 18.09% Black, 25.49% Hispanic, and 52.1% White. The analysis employed multinomial logistic regression, explicitly accounting for patient survival which revealed that transitioning to non-physician providers due to economic constraints ( aOR: 2.55 [95% CI: 2.35–2.74]), delays in medical care due to transportation limitations (aOR: 1.68 [1.62–1.74]), and the inability to afford follow-up care (aOR: 1.59 [1.52–1.66]) were all independently associated with an increased risk of 30-day readmission. Additionally, patients residing in ZIP codes characterized by high poverty rates and low health insurance coverage elevated the likelihood of readmission (aOR: 1.26 [1.22–1.29] and aOR: 1.28 [1.26–1.29], respectively). Conversely, having a primary care provider and health insurance were associated with decreased odds of unplanned 30-day readmission.
Investigators concluded that SDoH emerged as a powerful indicators of unplanned readmission within 30 days following sepsis hospitalization. Incorporating SDoH data alongside traditional clinical factors could improve models for predicting readmission risk.
