Publication: A retrospective analysis of causes for readmission to hospital and intensive care unit in patients discharged from intensive care units
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Ulusaloğlu, Ceyda
Ceylan, İlkay
Girgin, Nermin Kelebek
İsçimen, Remzi
Kahveci, Ferda Şöhret
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Galenos Yayıncılık
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Abstract
Objective: Intensive care unit (ICU) readmission is a common and unwanted situation. Mortality rates, length of stay in ICU and treatment expenses are also higher in readmitted patients. This study aimed to examine the hospital/ICU readmission rates and risk factors among patients discharged from the ICU.Materials and Methods: Patients older than 18 years who were hospitalised in the ICU between January 1, 2012 and October 31, 2016 and were re-admitted to the hospital/ICU within 30 days after discharge were retrospectively analysed.Results: A total of 510 patients met the inclusion criteria, of whom 91 (17.84%) patients were readmitted to the ICU. The average age was higher (p=0.002) among the readmitted patients. The acute physiology and chronic health evaluation-II and sequential organ failure assessment scores at admission and discharge, stability and workload index for transfer (SWIFT) scores at discharge and comorbid disease rates were higher among readmitted patients (p<0.05 for all). Patients discharged with mechanical ventilation support had higher readmission rates (p=0.041). In our risk analysis model, factors that increased the risk of readmission were identified as age [odds ratio (OR), 1.02; 95% confidence interval (CI), 1.01-1.03] and presence of renal disease (OR, 5.72; 95% CI, 2.81-11.65) among patient-related reasons.Conclusion: High acute physiology and chronic health evaluation and SWIFT scores during discharge as well as presence of comorbidities can predict hospital/ICU readmission.
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Keywords
Workload index, Transfer score, Risk-factors, Stability, Association, Severity, Illness, Swift score, Intensive care, Readmission, Acute physiology and chronic health evaluation-ii score, General & internal medicine