Intensive Care Unit Readmissions in a Level I Trauma Center

Area of Science:

• Trauma Surgery
• Critical Care Medicine
• Health Services Research

Background:

• Intensive care unit (ICU) readmissions increase patient morbidity, mortality, hospitalization duration, and healthcare costs.
• Understanding risk factors for ICU readmission in trauma patients is crucial for improving patient outcomes and resource allocation.

Purpose of the Study:

• To characterize risk factors associated with ICU readmission in a large cohort of trauma patients.
• To identify quality improvement strategies to mitigate ICU readmissions.

Main Methods:

• Retrospective cohort analysis of adult trauma patients admitted to a level I trauma center (2014-2021).
• Comparison of patients with ICU readmission versus those without, using descriptive statistics and logistic regression.
• Analysis of factors including age, Elixhauser Comorbidity Score, and ventilator use.

Main Results:

• 7.7% (278/3632) of trauma patients were readmitted to the ICU.
• Increasing age and higher Elixhauser Comorbidity Score were significant predictors of ICU readmission.
• An increasing trend in ICU readmission rates and a decreasing trend in ICU length of stay were observed over the study period.

Conclusions:

• Age, Elixhauser Comorbidity Score, and ventilator use are significant risk factors for ICU readmission in trauma patients.
• The institution identified a concerning trend of rising ICU readmissions and implemented successful mitigation strategies.
• These strategies reversed the trend, decreasing ICU readmission rates below the national average.