Cephalexin is associated with Lower Hospital Readmission Rates for Sepsis Patients at Regions Hospital based on Real World Evidence Study of Medicare Claims Data

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In Cephalexin, Sepsis

By: Sara Riascos  Apr. 20, 2022

Background:

Sepsis is frequently associated with hospital readmission. Readmission is a hospital quality measure that reflects dimensions of quality of inpatient care and also impacts overall programs by payors such as CMS’s Star Rating Program, HRRP and Value-Based Purchasing. Cephalexin is an antibiotic used to treat infections caused by susceptible bacteria such as pneumonia and other respiratory tract infections; and infections of the bone, skin, ears, and urinary tract.

Dexur’s analysis of Real World Evidence based on Medicare Claims data showed that the use of Cephalexin within 7 days of hospitalization was associated with lower hospital readmission rates for Sepsis Patients at Regions Hospital in Saint Paul, Minnesota. Reduction in readmission rates helps hospitals improve their outcomes for various cost and quality programs. Dexur is an approved entity to perform Medicare claims data analysis, which it uses to perform quality outcomes analysis. Dexur has published several papers with Harvard Medical School on quality outcomes related topics. Dexur’s analysis of Drugs and their impact on quality outcomes, such as readmissions and mortality, are used by Hospitals, IDNs, and ACOs to implement best practices and manage Real World Evidence based risk factors.

Methods:

We conducted a retrospective study using Dexur’s analysis of Real World Evidence from Medicare Claims data, for hospitalizations at Regions Hospital between January 2017 to September 2019. Our methodology criteria was as follows:

1. Inclusion Criteria: Selected Medical Hospitalizations with Primary Diagnosis with Sepsis related codes (Listed in table below)
2. Stratified Selected population into cohorts
   1. Sepsis patients who dispensed Cephalexin within 7 Days of Hospitalization using Part D drugs claims database
   2. Sepsis patients who did not dispense Cephalexin within 7 Days of Hospitalization
3. 30 Day readmission rates were analyzed for both population cohorts

Results:

Overall, Cephalexin was associated with lower hospital readmission rates for all Primary ICD Diagnosis Codes examined at Regions Hospital. For patients whose primary DRG Diagnosis was “Sepsis, unspecified organism”(A419) and when Cephalexin was used within 7 days of hospitalization, the readmission rate was 19.05% compared to the cohort where Cephalexin was not used, whose readmission rate was 22.53%. The readmission odds ratio for these cohorts was 0.81. The use of Cephalexin was associated with a 19% lower readmission rate when used within 7 days of hospitalization. The full list of studied ICD codes, readmission rates, odds ratios, confidence intervals, and percentage reduction in readmission with Cephalexin at Regions Hospital is shown below.

Primary ICD Diagnosis Code	Primary ICD Diagnosis Code Description	Total Hospitalizations without Cephalexin	Readmission Without Cephalexin	Readmission Rate without Cephalexin	Total Hospitalizations with Cephalexin	Readmission with Cephalexin	Readmission Rate with Cephalexin	Readmission Odds Ratio	Reduction in Readmission with Cephalexin (%)	Confidence Interval (-)	Confidence Intervals (+)
A419	Sepsis, unspecified organism	1,438

Dexur also leveraged Medicare claims data to understand what percentage of patients hospitalized with Sepsis were not prescribed Cephalexin within 7 days of discharge.

ICD CODE	Hospital	Hospitalizations with Sepsis	% of Hospitalizations without Cephalexin
A419	Kennedy University Hospital -Stratford	3,011	99.60%
	Centra Lynchburg General Hospital	2,895	99.62%
	Regions Hospital	1,450	99.17%

​Hospitalizations with Sepsis = Above Listed ICD Codes

If figures are shared with “At Least” - this implies that the drug utilization within 7 days post hospitalization is less than 11

Conclusions:

According to analysis of Real World Evidence of Medicare Claims data, for hospitalizations between January 2017 to September 2019, the use of Cephalexin within 7 days of hospitalization can lead to substantial reductions in hospital readmission rates of Sepsis patients at Regions Hospital. This analysis shows that a significant number of Patients are not dispensed Cephalexin after Sepsis hospitalizations at Regions Hospital or major US Hospitals.