Table 3.
All-cause adjusted a healthcare resource utilization and costs among Medicare patients with and without sepsis: 12-months postindex follow-up.
| Primary CDI only | Any recurrent CDI b | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Died | Died No Sepsis (Ref), N = 74,804 | Died Sepsis, N = 84,093 |
OR difference (95% CI) | p value | Died No Sepsis (Ref), N = 20,332 | Died sepsis, N = 33,526 | OR difference (95% CI) | p value | |
| Inpatient hospitalization (yes: ⩾ 1) | % | 91.7 | 96.4 | 2.4 (2.3, 2.5) | <0.0001 | 95.5 | 99.6 | 10.6 (9.3, 12.2) | <0.0001 |
| ICU stay (yes: ⩾1) | % | 16.4 | 30.0 | 2.2 (2.1, 2.3) | <0.0001 | 38.9 | 68.2 | 3.4 (3.3, 3.5) | <0.0001 |
| LOS (days) | Mean | 11.3 | 12.4 | 1.1 (1.1, 1.1) | <0.0001 | 9.6 | 11.7 | 2.1 (2.1, 2.1) | <0.0001 |
| Total cost (PPPM) c | Mean | $26,771 | $37,492 | $10,721 ($10,652, $10,792) | <0.0001 | $29,396 | $45,399 | $16,003 ($15,867, $16,138) | <0.0001 |
| Survived | Survived No sepsis (Ref), N = 135,636 |
Survived Sepsis, N = 51,360 |
OR difference (95% CI) | p value | Survived No sepsis (Ref), N = 62,829 | Survived Sepsis, N = 34,909 | OR difference (95% CI) | p value | |
| Inpatient hospitalization (yes: ⩾1) | % | 86.3 | 98.4 | 9.5 (8.9, 10.1) | <0.0001 | 88.6 | 99.3 | 18.5 (16.6, 20.7) | <0.0001 |
| ICU stay (yes: ⩾1) | % | 15.3 | 34.7 | 3.0 (2.9, 3.0) | <0.0001 | 21.0 | 48.1 | 3.5 (3.4, 3.6) | <0.0001 |
| LOS (days) | Mean | 7.2 | 9.0 | 1.8 (1.8, 1.8) | <0.0001 | 6.9 | 8.8 | 1.9 (1.9, 1.9) | <0.0001 |
| Total cost (PPPM) c | Mean | $5,551 | $9,567 | $4,016 ($3,970, $4,063) |
<0.0001 | $6,611 | $11,818 | $5,207 ($5,138, $5,277) | <0.0001 |
Logistic regression models with binomial distribution used for hospitalization and ICU outcomes; generalized linear models with gamma distribution and log link used for LOS and cost outcomes. Adjusted for age at index date (65–74, 75–84, and 85+ years), gender, race (White, Black, and other/unknown), geographic census region (MW, NE, S, and W), dual eligible, original reason for entitlement to Medicare (aged, disabled, and ESRD), CCI score (continuous), myocardial infarction, congestive heart failure, peripheral vascular disease, cerebrovascular disease, dementia, chronic obstructive pulmonary disease, rheumatologic disease, peptic ulcer disease, mild liver disease, moderate/severe liver disease, diabetes without complications, diabetes with complications, hemiplegia or paraplegia, renal disease, malignancy, metastatic solid tumor, ulcerative colitis, Crohn’s disease, type 1 diabetes, abnormality of gait, abnormal loss of weight and underweight, adult failure to thrive, debility, difficulty in walking, fall, muscle weakness, pressure ulcer, transplants, gastrointestinal surgery, enteral feeding, and chemotherapy.
Any recurrent CDI during follow-up of up to 12 months.
Inflation adjusted to 2018 $US.
CI, confidence interval; ICU, intensive care unit; LOS, length of stay; OR, odds ratio; PPPM, per-patient per-month.