Table 3. Multivariate Regression Results for 1-Year Mortality Among All Sepsis Survivors and Hospice Enrollment Among Decedents.
| Characteristic | Death Within 1 y of Sepsis Discharge, OR (95% CI) (n = 87 413) | P Value | Hospice Enrollment Among Decedents, OR (95% CI) (n = 24 423) | P Value |
|---|---|---|---|---|
| Demographic | ||||
| Age, y | ||||
| 65-74 | 1 [Reference] | 1 [Reference] | ||
| <65 | 0.84 (0.79-0.89) | <.001 | 0.76 (0.69-0.84) | <.001 |
| 75-84 | 1.08 (1.03-1.13) | <.001 | 1.23 (1.14-1.32) | <.001 |
| ≥85 | 1.47 (1.40-1.54) | <.001 | 1.49 (1.37-1.61) | <.001 |
| Race/ethnicity | ||||
| Non-Hispanic white | 1 [Reference] | 1 [Reference] | ||
| Black | 1.04 (0.98-1.09) | .12 | 0.67 (0.61-0.73) | <.001 |
| Hispanic | 0.91 (0.84-0.98) | .01 | 0.81 (0.71-0.92) | .001 |
| Other | 0.84 (0.76-0.92) | <.001 | 0.64 (0.54-0.76) | <.001 |
| Sex | ||||
| Female | 0.85 (0.82-0.87) | <.001 | 1.11 (1.05-1.17) | <.001 |
| Medicaid eligible | 0.94 (0.90-0.98) | .005 | 0.77 (0.72-0.82) | <.001 |
| Comorbidities | ||||
| Metastatic cancer, lymphoma, solid tumor without metastasis | 3.66 (3.50-3.83) | <.001 | 2.25 (2.11-2.41) | <.001 |
| Hypertension | 0.87 (0.84-0.90) | <.001 | 0.95 (0.89-1.00) | .06 |
| Fluid and electrolyte disorders | 1.03 (1.00-1.07) | .05 | 0.99 (0.94-1.05) | .76 |
| Deficiency anemias | 1.18 (1.14-1.22) | <.001 | 1.02 (0.97-1.08) | .48 |
| Renal failure | 1.37 (1.32-1.42) | <.001 | 0.94 (0.88-0.99) | .02 |
| Chronic pulmonary disease | 1.18 (1.14-1.23) | <.001 | 0.89 (0.84-0.95) | <.001 |
| Diabetes | 0.99 (0.96-1.03) | .63 | 0.90 (0.85-0.96) | <.001 |
| Congestive heart failure | 1.35 (1.30-1.40) | <.001 | 0.85 (0.80-0.90) | <.001 |
| Obesity | 0.76 (0.69-0.76) | <.001 | 0.84 (0.76-0.92) | <.001 |
| Depression | 0.93 (0.89-0.98) | .003 | 1.13 (1.04-1.23) | .003 |
| Peripheral vascular disease | 1.20 (1.14-1.26) | <.001 | 0.84 (0.77-0.91) | <.001 |
| Weight loss | 1.50 (1.43-1.58) | <.001 | 1.06 (0.98-1.14) | .15 |
| Alzheimer disease and associated disorders | 1.13 (1.09-1.18) | <.001 | 1.09 (1.02-1.16) | .009 |
| Index Sepsis Discharge | ||||
| Sepsis infection source | ||||
| Bone/joint/skin/tissue | 1.03 (0.98-1.08) | .30 | 0.78 (0.72-0.85) | <.001 |
| Central nervous system | 0.71 (0.51-0.97) | .03 | 0.75 (0.41-1.35) | .33 |
| Pneumonia and other respiratory | 1.14 (1.09-1.18) | <.001 | 0.94 (0.89-1.00) | .04 |
| Postoperative | 0.58 (0.51-0.67) | <.001 | 1.02 (0.79-1.31) | .89 |
| Sepsis severity | ||||
| Sepsis | 1 [Reference] | 1 [Reference] | ||
| Severe sepsis | 1.30 (1.23-1.37) | <.001 | 1.04 (0.96-1.14) | .35 |
| Septic shock | 1.14 (1.05-1.24) | .003 | 0.88 (0.76-1.01) | .06 |
| Intensive or cardiac care unit admission | 1.07 (1.03-1.11) | <.001 | 0.91 (0.86-0.96) | <.001 |
| Surgical admission type | 0.70 (0.67-0.73) | <.001 | 0.90 (0.83-0.98) | .01 |
| Home Health Assessment Within 7 d of Sepsis Discharge | ||||
| Indicators for risk of hospitalization on home health assessment | ||||
| No risks | 1 [Reference] | 1 [Reference] | ||
| Decline in mental, emotional, or behavioral condition | 0.99 (0.95-1.04) | .63 | 1.05 (0.98-1.13) | .18 |
| Multiple hospitalizations (≥2 in past 12 mo) | 1.21 (1.17-1.26) | <.001 | 1.01 (0.96-1.07) | .75 |
| Frailty indicators (weight loss, self-reported exhaustion) | 1.07 (1.03-1.11) | <.001 | 1.04 (0.98-1.10) | .19 |
| Assessment of overall health statusa | ||||
| No risk | 1 [Reference] | 1 [Reference] | ||
| Temporarily high risks but likely to return to stable condition | 0.96 (0.88-1.04) | .35 | 1.02 (0.88-1.19) | .76 |
| Fragile health/ongoing risks of complications or death | 1.39 (1.27-1.51) | <.001 | 1.23 (1.06-1.43) | .008 |
| Serious progressive conditions that could lead to death within 1 y | 2.21 (2.01-2.44) | <.001 | 1.40 (1.19-1.65) | <.001 |
| Vision | ||||
| No impairment | 1 [Reference] | 1 [Reference] | ||
| Partially impaired | 0.96 (0.93-1.00) | .81 | 0.98 (0.92-1.05) | .57 |
| Severely impaired | 0.97 (0.87-1.08) | .61 | 1.07 (0.90-1.27) | .46 |
| Speech and oral expression | ||||
| No impairment | 1 [Reference] | 1 [Reference] | ||
| Minimal impairment | 1.02 (0.98-1.07) | .34 | 1.01 (0.94-1.09) | .78 |
| Moderate to severe impairment | 1.09 (1.02-1.17) | .01 | 1.11 (0.99-1.24) | .07 |
| Unable to speak | 1.13 (0.99-1.30) | .07 | 0.94 (0.76-1.15) | .53 |
| Cognitive function | ||||
| No impairment | 1 [Reference] | 1 [Reference] | ||
| Mild | 0.99 (0.95-1.04) | .78 | 1.07 (1.00-1.15) | .06 |
| Moderate | 1.15 (1.04-1.26) | .006 | 1.14 (0.98-1.32) | .09 |
| Severe | 1.08 (0.92-1.27) | .35 | 0.78 (0.62-0.98) | .04 |
| Living arrangements | ||||
| Lives alone | 1 [Reference] | 1 [Reference] | ||
| Lives with someone | 1.07 (1.02-1.12) | .003 | 1.16 (1.08-1.26) | <.001 |
| Lives in congregate (eg, assisted living) | 1.21 (1.12-1.31) | <.001 | 1.93 (1.69-2.19) | <.001 |
| ADL and/or IADL dependencies | ||||
| 0-2 | 1 [Reference] | 1 [Reference] | ||
| 3-5 | 1.12 (1.05-1.19) | <.001 | 1.18 (1.05-1.33) | .005 |
| 6-8 | 1.34 (1.25-1.43) | <.001 | 1.16 (1.04-1.31) | .01 |
| 9-11 | 1.90 (1.78-2.03) | <.001 | 1.22 (1.08-1.37) | .001 |
| 12-13 | 2.80 (2.57-3.05) | <.001 | 1.15 (0.99-1.32) | <.07 |
| Presence of dyspnea | ||||
| Not short of breath | 1 [Reference] | 1 [Reference] | ||
| With moderate exertion/walking >20 ft, climbing stairs | 1.10 (1.05-1.16) | .02 | 0.94 (0.87-1.03) | .21 |
| With minimal exertion | 1.30 (1.23-1.37) | <.001 | 0.95 (0.86-1.04) | .02 |
| At rest (during day or night) | 1.53 (1.42-1.66) | <.001 | 0.87 (0.78-0.99) | .03 |
| Frequency of pain interfering with activity | ||||
| No pain | 1 [Reference] | 1 [Reference] | ||
| Sometimes | 0.90 (0.86-0.95) | <.001 | 1.00 (0.92-1.08) | .94 |
| Often | 0.90 (0.86-0.94) | <.001 | 0.98 (0.92-1.05) | .59 |
| Log likelihood | −45 212.91 | −15 825.15 | ||
| Akaike information criterion | 90 537.81 | 31 762.31 | ||
Abbreviations: ADL, activities of daily living; IADL, instrumental ADLs; OR, odds ratio.
a
Patients with an “unknown or unclear” or missing response for overall health status were excluded from regression analyses (n = 168).