Characteristics of patients readmitted to intensive care unit: a nested case-control study
1Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
Objectives:
To evaluate the pattern of unplanned readmissions to the intensive care unit and identify patients at risk of readmission.
Design:
Nested case-referent study.
Setting:
Tertiary hospital, Hong Kong.
Patients:
A total of 146 patients with unplanned intensive care unit readmission were compared with 292 control patients who were discharged from the intensive care unit alive and never readmitted. Cases and controls were matched for age, gender, and disease severity.
Main Outcome Measures:
Patient demographics, initial and pre-discharge clinical parameters, reasons for readmission, and outcomes were studied.
Results:
During the 30-month study period, the readmission rate was 5.1%. Readmitted patients had significantly higher mortality and longer mean hospital lengths of stay (both P<0.001). Most patients in this cohort (36.3%) were readmitted for a respiratory cause. Based on classification tree analysis, postoperative patients with sepsis (adjusted P=0.043), non-operative septic patients with fluid gain 24 hours pre-discharge (adjusted P=0.013), and non-septic patients with increased sputum quantity on discharge (adjusted P=0.006) were significantly associated with intensive care unit readmission.
Conclusion:
Incomplete resolution of respiratory conditions remained an important reason for potentially preventable intensive care unit readmission. Attention to fluid balance and sputum quantity before intensive care unit discharge might prevent unplanned intensive care unit readmission.
Related Concept Videos
01:29Nursing Interventions II: Selecting and Classifying the Nursing Interventions
01:21Planning Nursing Care I
01:26Acute Coronary Syndrome V: Nursing Management
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...