Readmission to Surgical Intensive Care Increases Severity-Adjusted Patient Mortality

Abstract

Readmission to the SICU significantly increases the risk of death beyond that predicted by the APACHE II or SAPS scores alone. Higher APACHE II and SAPS scores upon discharge from the SICU and longer SICU LOS are associated with an increased incidence of readmission to the SICU on the same hospital stay. These results may be used to optimize the timing of SICU discharge and reduce the chance of readmission to intensive care.

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

“…5,7,11,[14][15][16] Readmitted patients tend to be older, and have higher severity scores on initial admission and on discharge. 1,5,8,15,17 Recently, Gajic et al 18 produced a prediction model with acceptable validity.…”

“…[1][2][3][4][5] Consistently, readmitted patients had much poorer outcomes, higher hospital mortality, and their length of stay (LOS) in hospital was longer. 1,3,[5][6][7][8][9] Readmissions due to premature ICU discharge are potentially preventable, and may be attributed to deterioration of the primary or existing medical condition. Nevertheless, some readmissions are unavoidable, as there can be occurrence of new complications at any time after initial ICU discharge.…”

Fatores preditores precoces de reinternação em unidade de terapia intensiva

“…(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).…”

Intensive care performance: How should we monitor performance in the future?

“…Readmitted patients are most often the sickest in the ICU; therefore, it is an unexpected and unfavorable event for the patient and is associated with a more severe outcome [48][49][50][51][52][53][54][55][56][57] . Moreover, a strategy to reduce premature discharges in patients at high risk of in-hospital death could result in a reduction of post-ICU mortality (Daly et al [58] : 39% reduction in mortality) [48,57,58] .…”