Post-Sepsis Vulnerability Profiles Linked to 30-Day Readmission in Older Home Health Patients

Researchers analyzed Medicare fee-for-service beneficiaries aged 65 years or older who transitioned to home health care after a sepsis hospitalization between January 2021 and December 2022. Using clustering, they grouped 21,888 index stays according to risk factors recorded during hospitalization and at the first post-discharge home health assessment, then assessed associations with all-cause rehospitalization within 30 days.

Two profiles emerged, differing mainly in the extent of post-acute impairment. The higher-vulnerability profile included greater functional dependence, cognitive and behavioral impairment, urinary and bowel incontinence, difficulty following medical instructions, and more prior health care use. Its 30-day rehospitalization rate was 27.8%, compared with 21.1% in the lower-vulnerability group (p<0.001). The adjusted odds of rehospitalization were 1.48 times higher (95% CI 1.38–1.58; p<0.001).

The findings describe risk patterns in older sepsis survivors receiving home health care; they do not establish that cluster-informed care coordination reduces readmissions. The retrospective study relied on available assessment data and its results may not apply to sepsis survivors in other care settings or populations. The authors propose evaluating whether these profiles can support tailored post-acute care.