Intensive care unit readmission and unexpected death after emergency general surgery

Area of Science:

• Critical Care Medicine
• Surgical Outcomes
• Health Informatics

Background:

• Intensive care unit (ICU) readmission and unexpected death are significant concerns following hospitalization.
• Limited data exists on these adverse events specifically for patients undergoing emergency general surgery (EGS).

Purpose of the Study:

• To investigate risk factors for ICU readmission or unexpected death in EGS patients.
• To develop a predictive model for these adverse events within 72 hours of discharge.

Main Methods:

• Analysis of 1133 EGS patients from the MIMIC-IV database.
• Logistic regression to identify independent risk factors.
• Development of a nomogram for risk prediction.

Main Results:

• Peripheral vascular disease, atrial fibrillation, vasopressor use, vital sign abnormalities, low platelet count, and low Glasgow Coma Scale score were independent risk factors.
• The nomogram demonstrated moderate accuracy (AUC 0.852), outperforming the SWIFT score.

Conclusions:

• A nomogram integrating physiological, laboratory, and comorbidity data can predict ICU readmission or death within 72 hours post-EGS.
• This tool aids ICU physicians in making informed discharge decisions for critically ill surgical patients.