Pre-Sepsis Length of Hospital Stay and Mortality: A Nationwide Multicenter Cohort Study
- Author:
Joong-Yub KIM
1
;
Hong Yeul LEE
;
Jinwoo LEE
;
Dong Kyu OH
;
Su Yeon LEE
;
Mi Hyeon PARK
;
Chae-Man LIM
;
Sang-Min LEE
;
Author Information
- Publication Type:Original Article
- From:Journal of Korean Medical Science 2024;39(9):e87-
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:Prolonged length of hospital stay (LOS) is associated with an increased risk of hospital-acquired conditions and worse outcomes. We conducted a nationwide, multicenter, retrospective cohort study to determine whether prolonged hospitalization before developing sepsis has a negative impact on its prognosis.
Methods:We analyzed data from 19 tertiary referral or university-affiliated hospitals between September 2019 and December 2020. Adult patients with confirmed sepsis during hospitalization were included. In-hospital mortality was the primary outcome. The patients were divided into two groups according to their LOS before the diagnosis of sepsis: early- (< 5 days) and late-onset groups (≥ 5 days). Conditional multivariable logistic regression for propensity score matched-pair analysis was employed to assess the association between lateonset sepsis and the primary outcome.
Results:A total of 1,395 patients were included (median age, 68.0 years; women, 36.3%).The early- and late-onset sepsis groups comprised 668 (47.9%) and 727 (52.1%) patients.Propensity score-matched analysis showed an increased risk of in-hospital mortality in the late-onset group (adjusted odds ratio [aOR], 3.00; 95% confidence interval [CI], 1.69–5.34).The same trend was observed in the entire study population (aOR, 1.85; 95% CI, 1.37–2.50).When patients were divided into LOS quartile groups, an increasing trend of mortality risk was observed in the higher quartiles (Pfor trend < 0.001).
Conclusion:Extended LOS before developing sepsis is associated with higher in-hospital mortality. More careful management is required when sepsis occurs in patients hospitalized for ≥ 5 days.
