Quantifying the Risks of Hospitalization—Is It Really as Safe as We Believe?

Mao, Frances; Greysen, S. Ryan

doi:10.12788/jhm.3282

Cited by 2 publications

(2 citation statements)

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“… 18 19 For this reason, some physicians warn that hospitalization itself should be viewed as a procedure or intervention with inherent risks for all who receive it. 11 Along this line, to our knowledge, the present study for the first time demonstrates that prolonged hospitalization negatively affects the clinical outcomes of sepsis.…”

Section: Discussionsupporting

confidence: 52%

“…While length of hospital stay (LOS) is affected by several factors, including disease severity, frailty, onset of complications, socioeconomic status, and family support, 5 6 7 8 9 prolonged hospitalization itself confers risks of unwanted adverse events, such as falls, nosocomial infection, decreased functional status, and malnutrition, eventually leading to worse patient outcomes. 10 11 12 Longer LOS has been reported to be associated with a higher adjusted mortality rate during and after hospitalization, as well as a higher risk of readmission in patients with chronic heart failure and acquired immunodeficiency syndrome. 13 14 With extended exposure to nosocomial pathogens and reduced physiological reserve due to preexisting illness, patients who develop sepsis after prolonged hospitalization may have a different host response than those who develop sepsis at an earlier stage.…”

Section: Introductionmentioning

confidence: 99%

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Pre-Sepsis Length of Hospital Stay and Mortality: A Nationwide Multicenter Cohort Study

Kim,

Lee,

Lee

et al. 2024

J Korean Med Sci

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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 late-onset 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 ( P for 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.

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Section: Discussionsupporting

confidence: 52%