Literature DB >> 19319635

Readmission to the intensive care unit: an indicator that reflects the potential risks of morbidity and mortality of surgical patients in the intensive care unit.

Khee-Siang Chan1, Che-Kim Tan, Chiu-Shu Fang, Chi-Lun Tsai, Ching-Cheng Hou, Kuo-Chen Cheng, Meng-Chih Lee.   

Abstract

PURPOSE: To investigate the characteristics and outcomes of surgical patients who were readmitted to the intensive care unit (ICU).
METHODS: The data were collected for all readmissions to the surgical ICUs in a tertiary hospital in the year 2003.
RESULTS: Of all the 945 ICU discharges, 110 patients (11.6%) were readmitted. They had a longer initial ICU stay (8.05 +/- 7.17 vs 5.22 +/- 4.95, P < 0.001) and were older and in a more severe condition than those not readmitted, but with a longer hospital stay and higher mortality rate (40% vs 3.6%, P < 0.001). A total of 26.4% of the readmission patients had an early readmission (<48 h), with a lower mortality rate than those with a late readmission (24.1% vs 45.7%, P = 0.049). A total of 46.4% of the patients were readmitted with the same diagnosis while the rest were readmitted with a new complication. Respiratory disease was the most common diagnosis for patients readmitted with a new complication (66.1%). The nonsurvivors had a significantly higher second Acute Physiology and Chronic Health Evaluation (APACHE II) score (22.1 +/- 8.8 vs.14.6 +/- 7.4, P < 0.001) and second Therapeutic Intervention Scoring System (TISS) score (30.1 +/- 8.7 vs 24.7 +/- 7.6, P = 0.001) and a longer stay in the first ICU admission (10.4 +/- 9 days vs 6.4 +/- 5 days, P = 0.010). A multivariate analysis showed that the first ICU length of stay and the APACHE II score at the time of readmission were the two risk factors for mortality.
CONCLUSION: The mortality of surgical patients with ICU readmission was high with respiratory complications being the most important issue.

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Year:  2009        PMID: 19319635     DOI: 10.1007/s00595-008-3876-6

Source DB:  PubMed          Journal:  Surg Today        ISSN: 0941-1291            Impact factor:   2.549


  16 in total

1.  National estimates of intensive care utilization and costs: Canada and the United States.

Authors:  P Jacobs; T W Noseworthy
Journal:  Crit Care Med       Date:  1990-11       Impact factor: 7.598

2.  Factors affecting mortality and morbidity after traumatic diaphragmatic injury.

Authors:  Halil Ozgüç; Sule Akköse; Gürol Sen; Mehtap Bulut; Ekrem Kaya
Journal:  Surg Today       Date:  2007-11-26       Impact factor: 2.549

3.  Discharge decision-making in a medical intensive care unit. Identifying patients at high risk of unexpected death or unit readmission.

Authors:  H B Rubins; M A Moskowitz
Journal:  Am J Med       Date:  1988-05       Impact factor: 4.965

4.  Discharge decision-making in a medical ICU: characteristics of unexpected readmissions.

Authors:  C Franklin; D Jackson
Journal:  Crit Care Med       Date:  1983-02       Impact factor: 7.598

5.  Reducing readmissions to the intensive care unit.

Authors:  S Russell
Journal:  Heart Lung       Date:  1999 Sep-Oct       Impact factor: 2.210

6.  Patients readmitted to the intensive care unit during the same hospitalization: clinical features and outcomes.

Authors:  L M Chen; C M Martin; S P Keenan; W J Sibbald
Journal:  Crit Care Med       Date:  1998-11       Impact factor: 7.598

7.  Factors affecting postoperative morbidity and mortality in isolated coronary artery bypass graft surgery.

Authors:  Abbasali Karimi; Hossein Ahmadi; Saeed Davoodi; Namvar Movahedi; Mehrab Marzban; Kyomars Abbasi; Abbas Salehi Omran; Saeed Sadeghian; Parin Yazdanifard; Seyed Hesameddin Abbasi; Nader Fallah
Journal:  Surg Today       Date:  2008-09-27       Impact factor: 2.549

8.  A case-control study of patients readmitted to the intensive care unit.

Authors:  C G Durbin; R F Kopel
Journal:  Crit Care Med       Date:  1993-10       Impact factor: 7.598

9.  Discharge decision-making by intensivists on readmission to the intensive care unit.

Authors:  Kyung Bong Yoon; Shin Ok Koh; Dong Woo Han; One Chul Kang
Journal:  Yonsei Med J       Date:  2004-04-30       Impact factor: 2.759

10.  Validation of APACHE II score in a surgical intensive care unit.

Authors:  F G Chen; K F Koh; M H Goh
Journal:  Singapore Med J       Date:  1993-08       Impact factor: 1.858

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  20 in total

1.  Current status of and prospects for the English medical journal Surgery Today.

Authors:  Yoshihiko Maehara; Yoshihiro Kakeji
Journal:  Surg Today       Date:  2010-12       Impact factor: 2.549

2.  The epidemiology of intensive care unit readmissions in the United States.

Authors:  Sydney E S Brown; Sarah J Ratcliffe; Jeremy M Kahn; Scott D Halpern
Journal:  Am J Respir Crit Care Med       Date:  2012-01-26       Impact factor: 21.405

3.  Frequency, characteristics, and outcomes of pediatric patients readmitted to the cardiac critical care unit.

Authors:  Patricia Bastero-Miñón; Jennifer L Russell; Tilman Humpl
Journal:  Intensive Care Med       Date:  2012-05-16       Impact factor: 17.440

Review 4.  Surgical intensive care unit - essential for good outcome in major abdominal surgery?

Authors:  Georg R Linke; Markus Mieth; Stefan Hofer; Birgit Trierweiler-Hauke; Jürgen Weitz; Eike Martin; Markus W Büchler
Journal:  Langenbecks Arch Surg       Date:  2011-03-03       Impact factor: 3.445

5.  Residual Paralysis: Does it Influence Outcome After Ambulatory Surgery?

Authors:  Hassan Farhan; Ingrid Moreno-Duarte; Duncan McLean; Matthias Eikermann
Journal:  Curr Anesthesiol Rep       Date:  2014-12

6.  Accuracy of Clinicians' Ability to Predict the Need for Intensive Care Unit Readmission.

Authors:  Juan C Rojas; Patrick G Lyons; Teresa Jiang; Megha Kilaru; Leslie McCauley; Jamila Picart; Kyle A Carey; Dana P Edelson; Vineet M Arora; Matthew M Churpek
Journal:  Ann Am Thorac Soc       Date:  2020-07

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

Authors:  Tim K Timmers; Michiel Hj Verhofstad; Karl Gm Moons; Luke Ph Leenen
Journal:  World J Crit Care Med       Date:  2014-11-04

8.  Factors associated with increased risk of readmission to intensive care in Australia.

Authors:  J Renton; D V Pilcher; J D Santamaria; P Stow; M Bailey; G Hart; G Duke
Journal:  Intensive Care Med       Date:  2011-08-16       Impact factor: 17.440

9.  Intensive care unit bounce back in trauma patients: an analysis of unplanned returns to the intensive care unit.

Authors:  Samir M Fakhry; Stuart Leon; Chris Derderian; Hasan Al-Harakeh; Pamela L Ferguson
Journal:  J Trauma Acute Care Surg       Date:  2013-06       Impact factor: 3.313

Review 10.  Association of severity of illness and intensive care unit readmission: A systematic review.

Authors:  Evan G Wong; Ann M Parker; Doris G Leung; Emily P Brigham; Alicia I Arbaje
Journal:  Heart Lung       Date:  2016 Jan-Feb       Impact factor: 2.210

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