Proactive Telehealth-Based Sepsis Transition and Recovery Support, Hospital Readmission, and Mortality: A Randomized...

Area of Science:

• Critical Care Medicine
• Health Services Research
• Translational Science

Background:

• Sepsis survivors face significant post-discharge morbidity and mortality.
• Current health systems lack effective strategies to manage sepsis recovery.
• Improving outcomes for sepsis survivors is a critical healthcare challenge.

Purpose of the Study:

• To evaluate the effectiveness of the sepsis transition and recovery (STAR) program.
• To compare the STAR program's impact on post-discharge outcomes against usual care.
• To assess the STAR program's role in mitigating sepsis survivor morbidity and mortality.

Main Methods:

• A stepped-wedge cluster randomized clinical trial (ENCOMPASS) involving 7 US hospitals.
• Adults hospitalized with sepsis were enrolled, with clusters transitioning to the STAR program over time.
• The STAR program utilized navigator-led, telehealth-based interventions for 90 days post-discharge.

Main Results:

• The composite outcome of 90-day all-cause readmission or mortality did not differ significantly between groups (48.2% vs 48.0%).
• A statistically significant reduction in mortality was observed in the STAR group (17.3% vs 20.5%, P=.04).
• Readmission rates were higher in the STAR group, though not statistically significant (35.9% vs 33.5%).

Conclusions:

• The multicomponent, navigator-led STAR program did not reduce the composite endpoint of 90-day readmission or mortality.
• While not meeting the primary composite outcome, the STAR program showed a potential benefit in reducing sepsis survivor mortality.
• Further research may be needed to refine interventions for sepsis recovery and reduce readmissions.