Readmissions to a Surgical Intensive Care Unit: Incidence and Risk Stratification for Personalized Patient Care

Area of Science:

• Critical Care Medicine
• Surgical Outcomes
• Patient Safety

Background:

• Unplanned readmission to the surgical intensive care unit (UR-SICU) is a critical adverse event with significant implications for patient morbidity, length of stay, and mortality.
• Existing research on UR-SICU is often based on mixed intensive care units (ICUs), limiting its direct applicability to surgical patient cohorts.

Purpose of the Study:

• To identify independent risk factors associated with UR-SICU.
• To evaluate the impact of UR-SICU on patient outcomes, including hospital stay and mortality.

Main Methods:

• A retrospective cohort study was conducted on adult patients admitted to a surgical intensive care unit (SICU) after non-cardiac surgery between June 2021 and December 2022.
• Data collected included demographics, comorbidities, severity scores, treatments, and complications. Logistic regression and Kaplan-Meier survival analysis were used to identify predictors and assess survival.

Main Results:

• Of 1361 patients, 82 (6.4%) experienced UR-SICU. Independent predictors for UR-SICU included older age, active malignancy, and delirium during the initial SICU stay.
• UR-SICU patients had significantly longer hospital stays (46 vs. 13 days) and markedly higher in-hospital mortality (27.1% vs. 1.48%).
• Increased mortality persisted at 6 months and 1 year for patients with UR-SICU.

Conclusions:

• UR-SICU is associated with specific patient factors and significantly worsens patient outcomes, including prolonged hospitalization and increased short- and long-term mortality.
• Early identification of high-risk patients and implementation of tailored preventive strategies are crucial for reducing avoidable UR-SICU events.