Incidence and predictors of readmission to the cardiac surgery intensive care unit: A retrospective cohort study in Greece

Abstract

INTRODUCTION:Readmission in the intensive care unit (ICU) is a significant morbidity index, which has been related to poor patient outcomesAIM:To identify the preoperative and intraoperative risk factors for readmission in the cardiac surgery ICU.METHODS:We conducted a retrospective cohort study of 595 consecutive patients who were admitted to the cardiac surgery ICU of a tertiary hospital of Athens — Greece during the one-year period (September 2011-September 2012). Data collection was carried out, retrospectively, by the use of a short questionnaire and based on the review of medical and nursing patient records at December 2012.RESULTS:The incidence of ICU readmission was 3.7% (22/595). Respiratory disorders were the main reason for readmission (45.4%). Readmitted patients had a significantly higher in-hospital mortality compared to those requiring no readmission (P < 0.001). Multivariate analysis revealed that female gender [for males odds ratio (OR) 0.37, 95% confidence interval (CI) 0.15-0.89], high logistic EuroSCORE (OR 1.02, 95% CI 1.00-1.04), prolonged cardiopulmonary (CPB) duration (OR 1.01, 95% CI 1.00-1.02) and preoperative renal failure (OR 1.02, 95% CI 1.00-1.05) were the independent risk factors for readmission to the cardiac surgery ICU.CONCLUSIONS:One intraoperative and three preoperative variables are associated strongly with higher probability for ICU readmission. Shorter CPB duration could contribute to lower ICU readmission incidence. In addition, the early identification of high risk patients for readmission in the cardiac surgery ICU could encourage both the more efficient healthcare planning and resources allocation.

Serum creatinine as a predictor of mortality in patients readmitted to the intensive care unit after cardiac surgery: a retrospective cohort study in China

“…The different mortality rates reported in these studies may be related to the different standards of ICU readmission and the proportion of complex operations. In the present study, the primary causes of ICU readmission were respiratory disorders and cardiac dysfunction, consistent with the findings of many previous studies (7,(17)(18)(19). Respiratory and circulatory failure are common complications after cardiac surgery.…”

Comparison of Unplanned Intensive Care Unit Readmission Scores: A Prospective Cohort Study

“…For example, providing step-down units (e.g., respiratory or intermediate care units), for ICU-discharged patients who need more intensive monitoring and rehabilitation care than can be provided in a general medical ward, might be a good way to avoid unexpected clinical deterioration in some patients following ICU discharge [ 26 ]. Perhaps we are focusing too much on patient characteristics and ICU needs, and forgetting the type of hospital care required after discharge from the ICU [ 27 , 28 ].…”

Preventive and therapeutic noninvasive ventilation in cardiovascular surgery

“…In a single-center retrospective study [18], incidence and predictors of readmission to the ICU after cardiac surgery were evaluated over a 1-year period. The incidence of readmission was 3.7%.…”