Readmission to the Intensive Care Unit: Incidence, Risk Factors, Resource Use, and Outcomes. A Retrospective Cohort Study

• DOI: 10.1513/annalsats.201611-851oc
• Publication Date: 2017-05-21T22:25:15Z
• Authors: Carolina R. Ponzoni; Thiago D. Corrêa; Roberto R. Filho; Ary Serpa Neto; Murillo S. C. Ass...; Andreia Pardini; Guilherme P. P. S...
• Keywords: Interquartile range

Readmission to the intensive care unit (ICU) is associated with poor clinical outcomes, increased length of ICU and hospital stay, higher costs. Nevertheless, knowledge epidemiology readmissions, risk factors, attributable outcomes restricted developed countries.To determine effect readmissions on in-hospital mortality, incidence identify predictors compare resource use between readmitted nonreadmitted patients in a developing country.This retrospective single-center cohort study was conducted 40-bed, open medical-surgical private, tertiary São Paulo, Brazil. The Local Ethics Committee at Hospital Israelita Albert Einstein approved protocol, need for informed consent waived. All consecutive adult (≥18 yr) admitted June 1, 2013 July 2015 were enrolled this study.Comparisons made not ICU. Logistic regression analyses performed mortality. Out 5,779 ICU, 576 (10%) during same hospitalization. Compared patients, more often men (349 [60.6%] vs. 2,919 5,203 [56.1%]; P = 0.042), showed (median [interquartile range]) severity illness (Simplified Acute Physiology III score) index admission (50 [41-61] 42 [32-54], respectively, patients; < 0.001), frequently due medical reasons (425 [73.8%] 2,998 [57.6%], 0.001). Simplified score (P from ward (odds ratio [OR], 1.907; 95% confidence interval [CI], 1.463-2.487; vasopressors stay (OR, 1.391; CI, 1.130-1.713; 0.002), 0.001) independent readmission. After adjusting illness, readmission 4.103; 3.226-5.518; source, presence cancer, vasopressors, mechanical ventilation or renal replacement therapy, nighttime discharge death.Readmissions frequent strongly related outcomes. degree which are preventable as well main causes be further determined.