Characteristics of patients readmitted to intensive care unit: a nested case-control study

Tam, Oy Y.; Lam, Sin‐Man; Shum, Hoi‐Ping; Lau, CW; Chan, Kenny K C; Wu, Yan

doi:10.12809/hkmj133973

Cited by 5 publications

(4 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Song [7] also has reported 1087 patients undergoing thoracic surgery, including 237 patients undergoing curative resection of esophageal cancer and 850 patients undergoing lung resection and found the most common cause of ICU readmission was acute respiratory distress syndrome, accounting for 60.3%. In other types of surgery, the main attributable cause of ICU readmission was still respiratory-related complications, and the incidence ranged from 36.3% to 77.7% [7,9,17,[21][22][23]. This study also found that ICU readmission mainly occurred within 3 days after surgery, accounting for 46.5%, which was consistent with a national retrospective study [13].…”

Section: Discussionsupporting

confidence: 89%

“…Outcomes before and after 1:4 PSM Compared with patients who were not readmitted to ICU, patients readmitted to ICU were associated with increased postoperative pulmonary complications (44.2% vs 97.7%, P \ 0.001), prolonged median length of ICU stay (1[1-3] vs 7 [4][5][6][7][8][9][10][11], P \ 0.001), and hospital stay (9 [7][8][9][10][11] vs 19 [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30], P \ 0.001), higher hospitalization expenses (14,916 ± 3483 vs 19,850 ± 7595 dollars, P \ 0.001) and 30-day readmission rate (1.8% vs 9.3%, P = 0.011). However, there was no significant difference in 30-day mortality between the two groups (Table 4).…”

Section: Risk Factors For Icu Readmissionmentioning

confidence: 99%

See 1 more Smart Citation

Causes, Risk Factors and Outcomes of Patients Readmitted to the Intensive Care Unit After Esophageal Cancer Surgery: A Retrospective Cohort Study

Tong

Cao

et al. 2021

World j. surg.

View full text Add to dashboard Cite

Background Readmission to intensive care unit (ICU) after esophageal cancer surgery is a major concern and can be associated with increased adverse outcomes. This study aims to explore causes, risk factors and early outcomes. Methods We performed a monocentric retrospective analysis in 1140 patients who received esophageal cancer surgery in a higher volume surgeon group between January 2016 and December 2019, at Shanghai Chest Hospital. Univariate and multivariate analysis were performed to identify risk factors, and 1:4 propensity score matching (PSM) analysis was conducted to compare early outcomes. Results The incidence of ICU readmission was about 3.8% (43 of 1140). The most common cause was respiratory failure, found in 30 patients (70%). ICU readmission mainly occurred within 3 days after surgery, accounting for 46.5% (20 of 43), with the median length of stay was 3 days. Multivariate analysis identified heavy smoking (odds ratio[OR] = 2.445, 95% CI = 1.128 to 5.301, P = 0.024), intraoperative hypoxemia (OR = 2.461, 95% CI = 1.078 to 5.621, P = 0.033), mechanical ventilation during initial ICU stay (OR = 16.036, 95% CI = 7.332 to 35.074, P \ 0.001), postoperative anemia (OR = 3.993, 95% CI = 1.893 to 8.420, P \ 0.001) and unplanned reoperation (OR = 45.378, 95% CI = 13.023 to 158.122, P \ 0.001) as independent risk factors for ICU readmission. Compared with no-readmitted patients, patients readmitted to ICU were associated with increased postoperative pulmonary complications (44.2% vs 97.7%, P \ 0.001), prolonged median length of hospital stay (9[7-11] vs 19[13-30], P \ 0.001) and ICU stay (1[1-3] vs 7[4-11], P \ 0.001), higher hospitalization expenses (14,916 ± 3483 vs 19,850 ± 7595 dollars, P \ 0.001) and 30-day readmission rates (1.8% vs 9.3%, P = 0.011). After 1:4 PSM, the baseline characteristics were comparable and the matched results were similar. Conclusions This study identified five independent risk factors for ICU readmission, which were associated with adverse early outcomes. Preemptive attention given to pulmonary complications within three days after surgery may be important to prevent patients from ICU readmission.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Risk Factors For Icu Readmissionmentioning

confidence: 99%

Causes, Risk Factors and Outcomes of Patients Readmitted to the Intensive Care Unit After Esophageal Cancer Surgery: A Retrospective Cohort Study

Tong

Cao

et al. 2021

World j. surg.

View full text Add to dashboard Cite

show abstract

“…[ 5 , 14 , 15 , 19 ] In Lee et al's study [ 14 ] the mortality of the early readmitted patients was 27.5%, and these patients spent 18.9 ± 24.2 days (median, 11 days) in the ICU and 46.3 ± 48.4 days (median, 31 days) in the hospital, respectively. Another study [ 19 ] showed the similar findings that the mortality of patients readmitted to ICU was 30.8%, and their hospital LOS was 67.3 ± 66.4 days. Even in surgical ICU, the readmitted patients were found to have a long ICU stay (5.68+6.75 days) and high mortality rate of 34%.…”

Section: Discussionmentioning

confidence: 99%

The outcomes and prognostic factors of the patients with unplanned intensive care unit readmissions

Lin¹,

Chen²,

Chao

et al. 2018

Medicine

View full text Add to dashboard Cite

This retrospective cohort study investigated the outcomes of patients with unplanned intensive care unit (ICU) readmission.All of the patients readmitted to ICU within 48 hours between 2010 and 2016 were enrolled.A total of 99 patients early readmitted to ICU were identified and their mean age of the patients was 68.8 ± 14.8 years. Respiratory failure was the most common cause of ICU readmission (n = 48, 48.5%), followed by acute myocardial ischemia or worsening heart failure (n = 25, 25.3%), sepsis (n = 22, 22.2%), gastrointestinal disease (n = 16, 16.2%), and neurologic disease (n = 11, 11.1%). The median length of stay in the ICU and hospital was 7 (IQR, 4–11.5) and 32 (IQR, 15.5–48.5) days, respectively. A total of 34 patients died during the hospital stay and the rate of in-hospital mortality was 34.3%. Patients with higher APACHE II scores (adjusted odds ratio [OR], 1.17; 95% CI, 1.02–1.33), underlying malignancy (adjusted OR, 4.70; 95% CI, 1.19–18.57), and cardiovascular organ dysfunction (adjusted OR, 5.14; 95% CI, 1.24–21.38) were more likely to die.The mortality rate of ICU readmission patients was high, especially for those with higher APACHE II score, underlying malignancy and cardiovascular organ dysfunction.

show abstract

“…This result was consistent with those of previous studies. 1,[15][16][17][18][19] The incomplete resolution of respiratory diseases remains a significant cause of potentially preventable ICU readmissions. 19 Attention to sputum volume before ICU discharge may prevent unexpected readmissions.…”

Section: Transfer Reasonsmentioning

confidence: 99%

Status and Risk Factors in Patients Requiring Unplanned Intensive Care Unit Readmission Within 48 Hours: A Retrospective Propensity-Matched Study in China

Yin¹,

Sun²,

Zhang³

et al. 2023

RMHP

View full text Add to dashboard Cite

This study investigated the current status and related risk factors of 48-hour unplanned return to the intensive care unit (ICU) to reduce the return rate and improve the quality of critical care management. Methods: Data were collected from 2365 patients discharged from the comprehensive ICU. Multivariate and 1:1 propensity score matching analyses were performed. Results: Forty patients (1.69%) had unplanned readmission to the ICU within 48 hours after transfer. The primary reason for return was respiratory failure (16 patients, 40%). Furthermore, respiratory failure (odds ratio [OR] = 5.994, p = 0.02) and the number of organ failures (OR = 5.679, p = 0.006) were independent risk factors for unplanned ICU readmission. Receiver operating characteristic curves were drawn for the predictive value of the number of organ injuries during a patient's unplanned transfer to the ICU (area under the curve [AUC] = 0.744, sensitivity = 60%, specificity = 77.5%). Conclusion:The reason for patient transfer and the number of organ injuries during the process were independent risk factors for patients who were critically ill. The number of organs damaged had a predictive value on whether the patient would return to the ICU within 48 hours.

show abstract

Characteristics of patients readmitted to intensive care unit: a nested case-control study

Cited by 5 publications

References 38 publications

Causes, Risk Factors and Outcomes of Patients Readmitted to the Intensive Care Unit After Esophageal Cancer Surgery: A Retrospective Cohort Study

Causes, Risk Factors and Outcomes of Patients Readmitted to the Intensive Care Unit After Esophageal Cancer Surgery: A Retrospective Cohort Study

The outcomes and prognostic factors of the patients with unplanned intensive care unit readmissions

Status and Risk Factors in Patients Requiring Unplanned Intensive Care Unit Readmission Within 48 Hours: A Retrospective Propensity-Matched Study in China

Contact Info

Product

Resources

About