Association Between Inability to Stand at ICU Discharge and Readmission: A Historical Cohort Study

Area of Science:

• Critical Care Medicine
• Rehabilitation Medicine
• Health Services Research

Background:

• Assessing patient mobility at intensive care unit (ICU) discharge is crucial for predicting post-ICU outcomes.
• Limited data exists on the association between the inability to stand at ICU discharge and subsequent ICU readmission.

Purpose of the Study:

• To investigate the relationship between the inability to stand at ICU discharge and the probability of ICU readmission.
• To identify mobility status as a potential predictor of readmission in critical care patients.

Main Methods:

• A multicenter retrospective cohort study utilizing the Toronto Intensive Care Observational Registry (iCORE).
• Included patients mechanically ventilated for >4 hours, with an ICU stay ≥2 days, excluding those who died or transferred out.
• Assessed inability to stand at ICU discharge using the ICU Mobility Scale as the primary exposure.

Main Results:

• Inability to stand at ICU discharge was significantly associated with increased odds of ICU readmission (OR, 1.85; 95% CI, 1.31-2.62; p < 0.001) after adjusting for confounders.
• This association remained significant in patients with an ICU stay of 2 days or more.

Conclusions:

• The inability to stand at ICU discharge is a significant predictor of ICU readmission.
• Mobility assessment at discharge may aid in identifying high-risk patients for readmission, enabling targeted interventions.