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

The relationship between postoperative intensive care (ICU) admission following emergency general surgery (EGS) and emergency hospital readmission has not been widely investigated.

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.

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.

Indirect ICU admission is associated with increased emergency hospital readmission and healthcare costs for patients undergoing EGS.