Variation in rates of ICU readmissions and post-ICU in-hospital mortality and their association with ICU discharge practices

Sluisveld, Nelleke van; Bakhshi‐Raiez, Ferishta; Keizer, Nicolette de; Holman, Rebecca; Wester, Gert; Wollersheim, Hub; Hoeven, Johannes G. van der; Zegers, Marieke

doi:10.1186/s12913-017-2234-z

Cited by 29 publications

(31 citation statements)

References 49 publications

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“…This figure was lower than the mean value of 5.7% presented in a systematic review by Wong et al, in which 32,537 ICU readmissions were analyzed [17]. It was also lower in comparison with the data from the Dutch National Intensive Care Evaluation (NICE) registry, in which a readmission rate of 8.2% was noted among 42,040 ICU admissions [15]. Additionally, Polish patients were generally hospitalized for much longer in the ICU in comparison with other countries [15,24,25].…”

Section: Discussioncontrasting

confidence: 66%

“…It was also lower in comparison with the data from the Dutch National Intensive Care Evaluation (NICE) registry, in which a readmission rate of 8.2% was noted among 42,040 ICU admissions [15]. Additionally, Polish patients were generally hospitalized for much longer in the ICU in comparison with other countries [15,24,25]. These findings are not surprising.…”

Section: Discussionmentioning

confidence: 63%

“…This study was based on mandatory, administrative data (which resulted in major methodological limitations), but the observed mortality rate is entirely in agreement with the mortality in the Silesian region of Poland (44.1%). In other countries, however, ICU mortality is much lower and rarely exceeds 20% [3,6,7,15,17,18]. Generally, mortality rates among readmitted patients are significantly higher, exceeding the mortality for index ICU admissions by a large margin.…”

Section: Discussionmentioning

confidence: 99%

“…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%

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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: Discussioncontrasting

confidence: 66%

Section: Discussionmentioning

confidence: 63%

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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“…Readmission to intensive care unit (ICU) is frequently seen in critically ill patients (1,2). Nearly %10 of patients who has been discharged from ICU to a ward are being readmitted to ICU at the same hospital stay (3).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Readmitted Patients After Intensive Care Unit Discharge (Retrospective Study)

Çayören¹,

Müslümanoğlu²,

Sevdi³

et al. 2019

BMB

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Nearly %10 of the discharged patients are readmitted to intensive care unit (ICU) at the same hospital stay. Reduction of readmission rates could be used as a hospital performance indicator. Our aim is to analyse the reasons and results of readmissions of patients who were discharged to a general ward from ICU in a two-year period. Method: Readmissions of the patients who had been treated in our ICU between the dates of 01.01.2015-31.12.2016 were analysed retrospectively. Demographic characteristics of patients, readmission rates, initial admission indications and comorbidities, distribution of readmission indications, timing of readmission after discharge, distribution of patients in terms of mechanical ventilation need, discharge time of readmitted patients at initial admission to ICU after weaning, readmission mortality rates, Glasgow Coma Scale (GCS), APACHE-II and SOFA scores of patients at initial admission and readmission were analysed and compared. Results: 59 patients (3.55%) are readmitted to ICU after discharge at the same hospital stay. When examining the departments where the readmitted patients came from, it is seen that 19 patients (32.2%) were readmitted to ICU from department of general surgery. 22 of readmissions (37.29%) occurred within first 48 hours after discharge. The most common reasons of readmissions are for postoperative monitoring after revisional surgery (44.07%) and acute respiratory failure (40.68%). Conclusion: The patients who are discharged from ICU are at a high risk of being readmitted to ICU (35). Readmission to ICU is associated with higher mortality risk than the initial admission. The first step of reducing Amaç: Taburcu edilen hastaların yaklaşık %10' u yatış süresi içerisinde yeniden yoğun bakım ünitesine (YBÜ) gitmektedir. YBÜ'ye yeniden yatış oranlarındaki azalma, hastane performansında bir kalite göstergesidir. Bu çalışmadaki amacımız, YBÜ'den hastane içine, iki yıllık süre içerisinde taburcu edilen hastaların yeniden yatışlarının nedenlerini ve sonuçlarını analiz etmektir. Yöntem: 01.01.2015-31.12.2016 tarihleri arasında hastanemiz YBÜ'de tedavi edilen hastaların tekrar yatışları geriye dönük olarak incelendi. Hastaların demografik özellikleri, tekrar yatış oranları, hastaların ilk yatış endikasyonları ve yandaş hastalıkları, tekrar yatışların endikasyonlarına göre dağılımı, tekrar yatışın taburculuk sonrası ne zaman gerçekleştiği, mekanik ventilasyon ihtiyacına göre hastaların dağılımı, tekrar yatışı olan hastaların birinci kabullerinde weaning sonrası taburcu olma zamanı, tekrar yatışlardaki mortalite oranları, hastaların YBÜ'ye ilk ve tekrar yatışındaki Glasgow Koma Skalası (GCS), APACHE-II ve SOFA skorları incelenerek kıyaslandı. Bulgular: YBÜ'den taburcu edilen ve hastaneden taburcu olmadan tekrar yatışı yapılan hasta sayısı 59 olarak bulundu (%3,55). Hastaların tekrar geldikleri bölümler incelendiğinde en fazla 19 (%32,2) hasta Genel Cerrahi Kliniği'ndendi. Tekrar kabul edilen hastaların 22'si (%37,29) taburcu edildikten sonraki ilk 48 saat içinde gerçekleşti. T...

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Frontier of Smart Healthcare Engineering Management

Ding

Zhao

et al. 2022

AI for Risks

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Variation in rates of ICU readmissions and post-ICU in-hospital mortality and their association with ICU discharge practices

Cited by 29 publications

References 49 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

Evaluation of Readmitted Patients After Intensive Care Unit Discharge (Retrospective Study)

Frontier of Smart Healthcare Engineering Management

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