841. An Evaluation of Outcomes and Hospital Readmissions Among Individuals with Candidemia in Connecticut (2019-2020)

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Abstract Background In addition to significant morbidity and mortality, sepsis is a leading cause of hospital readmission. Candidemia, a leading cause of sepsis, has a particularly high morbidity and mortality rate. Previous studies defined risk factors for poor outcomes and readmission after general sepsis. However, specific risk factors for readmission after candidemia are unknown. Methods The study is retrospective cohort study of adults in Connecticut with an episode of candidemia between 2019-2022 using statewide surveillance data. Individuals were classified based on primary outcome (died versus survived) at incident admission. Candidemia survivors were further classified by readmission status. A descriptive analysis of demographics, healthcare related factors, and readmission characteristics was performed in univariate and multivariate analyses to identify factors associated with mortality and readmission after an episode of candidemia. Results Among 347 candidemia cases, 226 (65.1%) survived the incident episode. Those who survived were more likely to be younger (age > 65 = 70% vs age < 65 = 59.2%; p = 0.036), have community-onset infections (84.4% community-onset vs 47.2% hospital-onset; p < 0.001), and have an infection from a non-Candida albicans species (56.5% with C. albicans vs 70.8% with non-C. albicans; p = 0.006). In multivariate analysis, mortality was associated with hospital-onset infection [OR = 6.866, CI = 4.009 – 11.760]. Among survivors of the incident episode (n = 128), 56% were readmitted within 180 days post- incident episode. Of those readmitted, 13 (10.1%) were readmitted for a new incident candidemia episode. Readmission was associated with hospital-onset infection (OR=1.791, CI = 1.008 – 3.184).Table 1.Demographic and clinical factors of incident case outcome and readmissions, 2019-2020 (Abbreviated).* Indicates a significant p-value (p < 0.05)Table 2.Multivariate analysis for age and class of infection by incident case outcome and readmission status Conclusions Individuals with candidemia have a high risk of mortality and readmission. Individuals with hospital-onset infection are at particularly high risk of mortality and subsequent readmission. Efforts to prevent hospital-onset candidemia are critical. Additional measures focused on individuals with risk factors for readmission are needed to reduce overall morbidity and mortality associated with candidemia. Disclosures All Authors: No reported disclosures

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