Cut-Off Values of the Post-Intensive Care Syndrome Questionnaire for the Screening of Unplanned Hospital Readmission within One Year

Abstract

This study aimed to assign weights for subscales and items of the Post-Intensive Care Syndrome questionnaire and suggest optimal cutoff values for screening unplanned hospital readmissions of critical care survivors. Methods: Seventeen experts participated in an analytic hierarchy process for weight assignment. Participants for cutoff analysis were 240 survivors who had been admitted to intensive care units for more than 48 hours in three cities in Korea. We assessed participants using the 18-item Post-Intensive Care Syndrome questionnaire, generated receiver operating characteristic curves, and analysed cutoff values for unplanned readmission based on sensitivity, specificity, and positive likelihood ratios. Results: Cognitive, physical, and mental subscale weights were 1.13, 0.95, and 0.92, respectively. Incidence of unplanned readmission was 25.4%. Optimal cutoff values were 23.00 for raw scores and 23.73 for weighted scores (total score 54.00), with an area of under the curve (AUC) of .933 and .929, respectively. There was no significant difference in accuracy for original and weighted scores. Conclusion: The optimal cutoff value accuracy is excellent for screening of unplanned readmissions. We recommend that nurses use the Post-Intensive Care Syndrome Questionnaire to screen for readmission risk or evaluating relevant interventions for critical care survivors.

Post intensive care syndrome: A review of clinical symptoms, evaluation, intervention

“…Each entry is graded from 0 to 3, and the total PICSQ score ranges from 0 to 54, with the higher score indicating more severe symptoms. The PICSQ is recommended for both clinical and scientific research to assess PICS because of its high reliability, convergent validity, and discriminant validity [ 56 ].…”