Authors: J Renton D V Pilcher J D Santamaria P Stow M Bailey G Hart G Duke
Publish Date: 2011/08/16
Volume: 37, Issue: 11, Pages: 1800-
Abstract
A retrospective longitudinal study of data for 38 Australian ICUs extracted from the Australian and New Zealand Intensive Care Society Adult Patient Database ANZICSADP for the years 2000–2007 Demographic diagnostic physiological and outcome data were analysed A multivariate model was constructed to identify risk factors for ICU readmission Outcomes examined included observed and riskadjusted inhospital mortalityA total of 247103 patients were discharged alive from their first ICU admission 13598 55 were readmitted at least once Variables associated with an odds ratio greater than 105 for readmission p 0001 were an initial ICU admission source other than elective surgery any chronic health variable on severity scoring tertiary hospital ICU and discharge between 6 pm and 6 am Five initial diagnoses were associated with an odds ratio OR greater than 2 for readmission p 0001 Inhospital mortality in readmitted patients was 207 compared with 44 in those not readmitted Readmission rates have not changed over the study period After adjustment for illness severity and readmission propensity ICU readmission remained significantly associated with inhospital mortality OR 54 95 confidence interval CI 51–57Many risk factors for increased ICU readmission were identified in this study including ICU discharge between 6 pm and 6 am This was the only modifiable variable studied Prospective studies are required to identify other factors and to determine whether interventions may reduce ICU readmission and its high associated inhospital mortality
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