Predicting death and readmission after intensive care discharge

Abstract

We identified risk factors associated with death and readmission to intensive care. It was not possible to produce a definitive model based on these risk factors for predicting death or readmission in an individual patient.

End-Stage Renal Disease Status and Critical Illness in the Elderly

“…Need for readmission to ICU is associated with poor outcome and may be a marker of quality of care (16,17). The observed readmission rates in our elderly cohort were similar to those reported in the literature for general ICU cohorts (16,17).…”

Fatores preditores precoces de reinternação em unidade de terapia intensiva

“…Another trial evidenced advanced age, increased hospital stay before ICU admission (at a ward or room), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and discharge to a high dependency patients unit, as readmission risk factors. (10) Patients from the ward are acknowledged as having increased ICU morbi-mortality risk, perhaps due to the lack of their underlying disease resolution before reaching the ICU, (8,16) but in our study, surgical population had shorter hospital length of stay before surgery leading to the ICU. Another important factor was advanced age, which is an acknowledged risk factor, because the elderly physiology who recovers from organ injuries at a slower rate, (17) and perhaps increased comorbidities rate.…”

“…(1,4) Our readmission rate was 11.5%, while in other studies it ranged from 2.8 to 14.5%. (1,3,7,(10)(11)(12) We analyzed early predictors of patient readmission, based on collected data at the onset of ICU stay. Advanced age, respiratory and/ or severe infections with sepsis admissions, and comorbidities were independently associated with increased ICU readmission likelihood in this population.…”

“…(1,5,6,10,11,13,14) Most analyzed the readmission causes, always trying to associate the underlying disease, mainly without definitive resolution, with increased readmission occurrence. In most studies, data regarding the end of the ICU stay were analyzed, as nosocomial infections and organ failure degree (SOFA and Logistic Organ Dysfuncion Score -LODS).…”

“…(18) Prognostic scores are useful for hospital mortality prediction in ICU populations, and were also associated with increased readmission likelihood. (4,10) However the points calculation is usually made with high weight for the variable age, mainly in the above 65 years old group. In APACHE II, for instance, an older than 75 years patient is given additional 6 points.…”