The Risk and Related Factors for Readmission to an ICU Within 7 Days in Mechanically Ventilated Subjects—A Nationwide Population-Based Cohort Study

Chu, Chao-Ting; Liu, Chin-Jung; Shih, Chuen-Ming; Kung, Pei‐Tseng; Tsai, Yuh-Show; Tsai, Wen‐Chen

doi:10.4187/respcare.03868

Cited by 4 publications

(4 citation statements)

References 28 publications

(29 reference statements)

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“…Furthermore, the collected data have already proved sufficient for gathering information on important trends and patterns [9,13,14]. The issue of the integrity of this local registry is important to note because the data for potential comparisons to our research typically come from large national registries [2,3,15,16].…”

Section: Discussionmentioning

confidence: 99%

“…In studies concerning ICU readmissions, the influence of older age has been emphasized as a predisposing factor [16,17,26]. In Poland, however, patients readmitted to the ICU were found not to differ from their non-readmitted counterparts in terms of age.…”

Section: Discussionmentioning

confidence: 99%

“…Patients hospitalized in Polish ICUs were more frequently admitted due to exacerbation of chronic respiratory failure, polytrauma, and infection without sepsis. In the literature, patients were more commonly readmitted when they were elderly and had pneumonia, heart failure or sepsis [16,25,26].…”

Section: Discussionmentioning

confidence: 99%

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Readmissions to General ICUs in a Geographic Area of Poland Are Seemingly Associated with Better Outcomes

Grochla

Saucha

Cieśla

et al. 2020

IJERPH

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Background: Various factors can contribute to high mortality rates in intensive care units (ICUs). Here, we intended to define a population of patients readmitted to general ICUs in Poland and to identify independent predictors of ICU readmission. Methods: Data derived from adult ICU admissions from the Silesian region of Poland were analyzed. First-time ICU readmissions (≤30 days from ICU discharge after index admissions) were compared with first-time ICU admissions. Pre-admission and admission variables that independently influenced the need for ICU readmission were identified. Results: Among the 21,495 ICU admissions, 839 were first-time readmissions (3.9%). Patients readmitted to the ICU had lower mean APACHE II (21.2 ± 8.0 vs. 23.2 ± 8.8, p < 0.001) and TISS-28 scores (33.7 ± 7.4 vs. 35.2 ± 7.8, p < 0.001) in the initial 24 h following ICU admission, compared to first-time admissions. ICU readmissions were associated with lower mortality vs. first-time admissions (39.2% vs. 44.3%, p = 0.004). Independent predictors for ICU readmission included the admission from a surgical ward (among admission sources), chronic respiratory failure, cachexia, previous stroke, chronic neurological diseases (among co-morbidities), and multiple trauma or infection (among primary reasons for ICU admission). Conclusions: High mortality associated with first-time ICU admissions is associated with a lower mortality rate during ICU readmissions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Readmissions to General ICUs in a Geographic Area of Poland Are Seemingly Associated with Better Outcomes

Grochla

Saucha

Cieśla

et al. 2020

IJERPH

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“…The transition from an ICU to the general ward represents a challenge in the management of critically ill patients, with some patients being at high risk for readmission [1][2]. Multiple risk factors for ICU readmission have been identified, such as older age, higher comorbidity score, and longer ICU stay [3][4].…”

Section: Introductionmentioning

confidence: 99%

The Impact of an Intensivist-Led Critical Care Transition Program

Neto¹,

Carvalho²,

Paixão³

et al. 2022

Cureus

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Objective: Evaluate the impact of a post-discharge critical care transition program (CTP) on intensive care unit (ICU) readmission, in-hospital mortality, and six-month survival.Methods: This was a prospective observational, single-center study, with a before-after design, in a critical care department in a tertiary hospital in Northern Portugal. Critically ill patients with ICU stay > 48 h or intermediate care stay >72 h or tracheostomized patients were included in the program. Historic controls included critically ill patients admitted in the six months prior to program implementation. The follow-up visit included a medical evaluation by an intensivist and a meeting with the attending physician. The primary outcome was critical care department readmission. Secondary outcomes were mortality at hospital discharge, 28-day, and six-month mortality. The readmission rate was compared between groups. Multivariate analysis and Kaplan-Meyer survival analysis were used to evaluate survival benefits.Results: Between September 2020 and March 2021, 132 patients were included in the CTP. The Control group included 196 patients. The intensivist's assessment led to management change in 15.1% of patients. The CTP group had a non-significant lower readmission rate (0.8% vs. 4.1%; p=0.09). Multivariate analysis showed a benefit for the CTP regarding in-hospital, 28-day, and six-month mortality. Kaplan-Meyer survival analysis showed improved survival in the CTP group.Conclusions: The CTP reduced, non-significantly, the readmission rate, and significantly improved inhospital and six-month mortality. Further analyses are needed to improve inclusion criteria and better allocate human resources.

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Readmission rate among survived patients with acute respiratory failure: 1-year study

Elsayed,

Farrag,

Abdelgawad

2024

Egypt J Bronchol

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Context Critically ill patients, especially those with respiratory failure associated with multiple comorbidities, are at risk of recurrent ICU admission and consuming a significant portion of medical resources. Aim To study the risk factors and common etiologies of readmission among surviving patients with acute respiratory failure in Mansoura University’s respiratory intensive care unit during the year 2023. Settings and design This was a retrospective cohort study. Patients and methods This study included all patients with acute respiratory failure who were admitted to Mansoura University’s respiratory intensive care unit (RICU), from January 2023 to December 2023. Deceased patients after initial admission or those with incomplete data were not included in the study. All data related to patient’s demographics, type of respiratory failure, type of respiratory support, associated comorbidities, length of ICU stay, and causes of readmission were collected from the registration system database. Results Eight-hundred-thirty (830) cases that were admitted to the Mansoura University’s RICU with respiratory failure in the year 2023 were enrolled in the study, and 84 cases (10.1%) of them were readmitted. COPD exacerbation was the most common cause of readmission (35.7%) followed by pneumonia (21.4%) and OSA exacerbation (20.2%). Results showed that the significant independent predictors of readmission were being male [AOR (95% CI): 1.8 (1.01–3.1), p: 0.046], having organ failure (renal/liver) [AOR (95% CI): 29.9 (7.9–113.4), p ≤ 0.001], and length of ICU stay more than 12 days [AOR (95% CI): 4.8 (2.6–8.6), p ≤ 0.001]. Also, the type of respiratory failure and the type of respiratory support received were significantly associated with readmission in the univariate analysis; however, they were insignificant in the multivariate analysis. Conclusion The rate of readmission was not high (only 10.3%). The most common causes of readmission were COPD exacerbation, followed by pneumonia and OSA exacerbation, respectively. Type of respiratory failure, male gender, the presence of other organ failure, and length of ICU stay are significant independent predictors of readmission in Mansoura University’s RICU during the year 2023. Therefore, higher-risk individuals should receive attention and careful assessment before discharge from the ICU to reduce the rate of readmission. Trial registration ClinicalTrials.gov identifier: NCT06291636.

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The Risk and Related Factors for Readmission to an ICU Within 7 Days in Mechanically Ventilated Subjects—A Nationwide Population-Based Cohort Study

Cited by 4 publications

References 28 publications

Readmissions to General ICUs in a Geographic Area of Poland Are Seemingly Associated with Better Outcomes

Readmissions to General ICUs in a Geographic Area of Poland Are Seemingly Associated with Better Outcomes

The Impact of an Intensivist-Led Critical Care Transition Program

Readmission rate among survived patients with acute respiratory failure: 1-year study

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