Hospital readmission after surviving sepsis: a systematic review of readmission reasons and meta-analysis of readmission rates

Purpose: To review the evidence regarding hospital readmission diagnoses and analyse related readmission rates following a sepsis admission.
Methods: Five databases, grey literature, and selected article reference lists were searched in May and June 2024. Included studies investigated sepsis survivor readmissions and reported readmission diagnoses and rates. Meta-analyses of readmission rates were performed.
Results: After screening, 51 studies were included, with most studies (46/51; 90.2 %) investigating adult survivors. Infection or sepsis were reported as the most common readmission reason in 18 of the 21 studies investigating three or more readmission diagnoses in adults. Meta-analyses showed that 4.7 % (95 % CI: 3.1 to 6.5 %, PI: 0.3–13.4 %, n = 11 studies) of adult survivors readmitted to hospital with another sepsis diagnosis at 30 days, 8.1 % (95 % CI: 4.5 to 12.7 %, PI: <0.1–29.0 %, n = 7) at 90 days, and 16.4 % (95 % CI: 11.3 to 22.2 %, PI: <0.1–96.3 %, n = 3) at one year. At 30 days 3.5 % (95 % CI: 2.2–5.0 %, PI: 0.3–10.0 %, n = 7) of adult survivors readmitted to hospital with a cardiovascular disease diagnosis.
Conclusions: Infection and sepsis are frequent readmission diagnoses for sepsis survivors, with one in 21 adult survivors readmitted for sepsis at 30-days.
PROSPERO registration: CRD42023455851.