1397: Sepsis Survivors’ Satisfaction With Support Services During and After Their Hospitalization

Huang, Cynthia; Daniels, Ron; Lembo, Angie; Heymann, Thomas; O’Brien, Jim; Hartog, Christiane S.; Reinhart, Konrad; Nguyen, H. Bryant

doi:10.1097/01.ccm.0000510071.45969.89

Cited by 4 publications

(4 citation statements)

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“…An international survey suggests a need for improved management after hospital discharge. Of 1475 patients who survived hospitalization for sepsis, there was only low to moderate satisfaction with support services after they were discharged . In addition, rehospitalization after sepsis accounts for 12.2% of all US hospital readmissions and 14.5% of readmission costs .…”

Section: Introductionmentioning

confidence: 99%

“…2 In-hospital mortality has declined, 3,4 from 35% in 2000 to 18% in 2012, resulting in a large number of sepsis survivors. Emerging data suggest that patients who survive sepsis frequently experience new symptoms, 5 long-term disability, 6 and worsening of chronic health conditions 7,8 for which they will seek care from many types of clinicians.…”

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confidence: 99%

“…Of 1475 patients who survived hospitalization for sepsis, there was only low to moderate satisfaction with support services after they were discharged. 5 In addition, re-hospitalization after sepsis accounts for 12.2% of all US hospital readmissions and 14.5% of readmission costs. 9 Therefore, improving medical care after sepsis hospitalizations may reduce health care utilization and costs.…”

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confidence: 99%

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Enhancing Recovery From Sepsis

Prescott

Angus

2018

JAMA

688

633

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In the months after hospital discharge for sepsis, management should focus on (1) identifying new physical, mental, and cognitive problems and referring for appropriate treatment, (2) reviewing and adjusting long-term medications, and (3) evaluating for treatable conditions that commonly result in hospitalization, such as infection, heart failure, renal failure, and aspiration. For patients with poor or declining health prior to sepsis who experience further deterioration after sepsis, it may be appropriate to focus on palliation of symptoms.

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Section: Introductionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Enhancing Recovery From Sepsis

Prescott

Angus

2018

JAMA

688

633

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“…Currently, post-acute care resources are not adequate to address the needs of sepsis survivors [11–14]. Inadequate post-sepsis care strategies are reflected by the high rates of adverse outcomes after sepsis hospital discharge such as increased mortality risk and strikingly high rates of healthcare utilization, including a 90-day hospital readmission rate of 40% and over 3,000,000,000 USD in potentially preventable costs [15–19].…”

Section: Introductionmentioning

confidence: 99%

Structured, proactive care coordination versus usual care for Improving Morbidity during Post-Acute Care Transitions for Sepsis (IMPACTS): a pragmatic, randomized controlled trial

Kowalkowski

Chou

McWilliams

et al. 2019

Trials

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AbstractsBackgroundHospital mortality for patients with sepsis has recently declined, but sepsis survivors still suffer from significant long-term mortality and morbidity. There are limited data that support effective strategies to address post-discharge management of patients hospitalized with sepsis.MethodsThe Improving Morbidity during Post-Acute Care Transitions for Sepsis (IMPACTS) study is a pragmatic, randomized controlled trial at three hospitals within a single healthcare delivery system comparing clinical outcomes between sepsis survivors who receive usual care versus care delivered through the Sepsis Transition and Recovery (STAR) program. The STAR program includes a centrally located nurse navigator using telephone counseling and electronic health record-based support to facilitate best-practice post-sepsis care strategies for patients during hospitalization and the 30 days after hospital discharge, including post-discharge review of medications, evaluation for new impairments or symptoms, monitoring existing comorbidities, and palliative care referral when appropriate. Adults admitted through the Emergency Department with suspected infection (i.e., antibiotics initiated, bacterial cultures drawn) and deemed, by previously developed risk-stratification models, high risk for readmission or death are included. Eligible patients are randomly allocated 1:1 to either Arm 1, usual care or Arm 2, STAR. Planned enrollment is 708 patients during a 6-month period. The primary outcome is the composite of all-cause hospital readmissions and mortality assessed 30 days post discharge. Secondary outcomes include 30- and 90-day hospital readmissions, mortality, emergency department visits, acute care-free days alive, and acute care and total costs.DiscussionThis pragmatic evaluation provides the most comprehensive assessment to date of a strategy to improve delivery of recommended post-sepsis care.Trial registrationClinicalTrials.gov, NCT03865602. Registered retrospectively on 6 March 2019.

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A patient cohort on long-term sequelae of sepsis survivors: study protocol of the Mid-German Sepsis Cohort

et al. 2017

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IntroductionAn increasing number of patients survive sepsis; however, we lack valid data on the long-term impact on morbidity from prospective observational studies. Therefore, we designed an observational cohort to quantify mid-term and long-term functional disabilities after intensive care unit (ICU)-treated sepsis. Ultimately, findings for the Mid-German Sepsis Cohort (MSC) will serve as basis for the implementation of follow-up structures for patients with sepsis and help to increase quality of care for sepsis survivors.Methods and analysisAll patients surviving ICU-treated sepsis are eligible and are recruited from five study centres in Germany (acute care hospital setting in Jena, Halle/Saale, Leipzig, Bad Berka, Erfurt; large long-term acute care hospital and rehabilitation setting in Klinik Bavaria Kreischa). Screening is performed by trained study nurses. Data are collected on ICU management of sepsis. On written informed consent provided by patients or proxies, follow-up is carried out by trained research staff at 3, 6 and 12 months and yearly thereafter. The primary outcome is functional disability as assessed by (instrumental) activities of daily living. Other outcomes cover domains like mortality, cognitive, emotional and physical impairment, and resource use. The estimated sample size of 3000 ICU survivors is calculated to allow detection of relevant changes in the primary outcome in sepsis survivors longitudinally.Ethics and disseminationThe study is conducted according to the current version of the Declaration of Helsinki and has been approved by four local/federal responsible institutional ethics committees and by the respective federal data protection commissioners. Results of MSC will be fed back to the patients and published in peer-reviewed journals.Trial registration numberGerman Clinical Trials Registry DRKS00010050.

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1397: Sepsis Survivors’ Satisfaction With Support Services During and After Their Hospitalization

Cited by 4 publications

References 0 publications

Enhancing Recovery From Sepsis

Enhancing Recovery From Sepsis

Structured, proactive care coordination versus usual care for Improving Morbidity during Post-Acute Care Transitions for Sepsis (IMPACTS): a pragmatic, randomized controlled trial

A patient cohort on long-term sequelae of sepsis survivors: study protocol of the Mid-German Sepsis Cohort

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