Sepsis drives more readmissions than medical conditions tracked by CMS

It may be time to add sepsis to the list of medical conditions that Medicare tracks under the Hospital Readmissions Reduction Program.

New research published in JAMA finds that sepsis accounts for more 30-day readmissions and is more costly than heart attacks, heart failure, chronic obstructive pulmonary disease and pneumonia—the four conditions tracked by the Centers for Medicare & Medicaid Services.

The findings highlight the need for coordinated efforts to develop new medical interventions to improve sepsis outcomes and reduce readmissions, researchers from the University of Pittsburgh School of Medicine and VA Pittsburgh Healthcare System said in a study announcement.

“Many people think infections and sepsis are short-term illnesses and that once patients are discharged from the hospital, they are better,” said senior author Sachin Yende, M.D., associate professor in the Pitt School of Medicine’s departments of Critical Care Medicine and Clinical and Translational Sciences, in the announcement. “But all research to date shows that sepsis has serious, lingering consequences, and patients continue to have problems well after they are discharged.”

Sepsis contributes to as many as 50% of all U.S. hospital deaths, according to previous research. The latest study, which analyzed 1 million hospitalizations associated with unplanned readmission using data from the 2013 Nationwide Readmissions Database, finds that it also accounts for 12.2% of readmissions—far higher than heart failure (6.7%), pneumonia (5%), COPD (4.6%) and heart attack (1.3%)

It also costs a lot more to treat the condition during readmissions. Researchers says the average cost per readmission for sepsis was $10,070, or $537 more than pneumonia,  $646 more than heart attack, $1,019 more than heart failure and $1,653 more than COPD.

“This really puts in perspective how important sepsis is,” lead author Florian B. Mayr, M.D., faculty member in Pitt’s Department of Critical Care Medicine and the Center for Health Equity Research and Promotion at the VA Pittsburgh, said in the study announcement.

“If we, as a nation, place such high emphasis on reducing readmissions for the other four conditions, then we really need to look for opportunities to improve outcomes for sepsis, which has a higher rate of readmission than heart failure.," Mayr said. “People who survive an initial episode of sepsis often don’t do well. They return to the hospital frequently, accrue new health conditions and have significantly elevated death rates.”

Meanwhile, to help clinicians improve the care and outcomes for critically ill patients with sepsis, JAMA also published updated sepsis treatment guidelines.