The association between ICU admission and emergency hospital readmission following emergency general surgery.

BACKGROUND: The relationship between postoperative intensive care (ICU) admission following emergency general surgery (EGS) and emergency hospital readmission has not been widely investigated.
METHODS: Retrospective analysis of registry data for patients undergoing EGS in Scotland, 2005-2007. Exposure of interest was ICU admission status (direct from theatre; indirect after initial care on ward; no ICU admission). The primary outcome was emergency hospital readmission within 30 days of discharge.
RESULTS: Thirty-seven thousand one hundred seventy-three patients were included in the analysis. Overall emergency readmission rate was 8% (n = 2983): 2756 (7.8%) in patients without postoperative ICU admission; 155 (12.1%) with direct ICU admission and 65 (14.7%) with indirect ICU admission. Indirect ICU admission was associated with increased hospital readmission rates (HR 1.24 [1.03, 1.49]; p = 0.024) compared with direct ICU admission. ICU admission was associated with increased three-year readmission rates (p = 0.006) and costs (p < 0.001) compared with initial ward care.
CONCLUSION: Indirect ICU admission is associated with increased emergency hospital readmission and healthcare costs for patients undergoing EGS. © The Intensive Care Society 2019.