الفهرس 
Criteria for Intensive Care Unit admissionOnly 14 pages are availabe for public view
 |  | from | 151 |  |  |
| | | from | 151 | | |
Abstract
Predictors and Outcome of Patients Readmitted to Intensive Care Unit
Elewa GM1, El-sharnouby NM1, Metwaly AA2, Zekry MR1, Elfawy DM1 and Ossimi AI 2
1: Anesthesia, Intensive Care and Pain Management Department, Faculty of Medicine-Ain Shams University, Cairo, Egypt
2: Intensive Care Department, Theodor Bilharz Research Institute, Giza, Egypt
Abstract:
Introduction: A high rate of Intensive Care Unit (ICU) readmission may indicate early ICU discharge, overused ICU or inadequate care outside the ICU. The aim of this study was to detect predictors of ICU readmission and outcome of such patients.
Methods: This prospective cohort study was conducted over 18 months. Patients were divided into 2 groups; ‘R’: patients readmitted to ICU during their hospital stay, and ‘N’: non-readmitted patients. Comparisons between both groups and between the recorded data of the readmitted group during their 1st (R1) and 2nd (R2) ICU admissions were done. We applied the Stability and Workload Index for Transfer (SWIFT) score to the patients at discharge day as a predictor of ICU readmission.
The 1ry outcome of this study was to predict the outcome of patients readmitted to ICU, whereas 2ry outcomes included reasons and predictors of ICU readmission.
Results: The study comprised 180 patients, 42 patients (23.3%) were readmitted to ICU, 14 patients (33%) of them died. The main ICU readmission causes were post operative complications [17 patients (44.5%)] and sepsis [12 patients (28.57%)], then respiratory, cardiac and metabolic causes [6 patients (14.29% each)]. Non readmitted patients showed higher 1st day APACHE III score [“N” 59(45%-70%) vs. “R” 52(48%-78%)], daily SOFA score [3.5(1.5%-5%) for ”N” group vs. 2 (1%-4%) for ”R” group], length of stay[”R”(4.0±3.9) days vs. “N” (5±4.53) days], need and duration of mechanical ventilation [“N” 20 patients (14.49%) for (9.13±3.1) days vs. “R” 4 patients (9.52%) for(2.4±7.6 )days]. Readmitted patients showed higher 1st day APACHE III [‘R1’52 (48%-78%) vs. ‘R2’75 (42%-93%)], daily SOFA [‘R1’2 (1%-4%)vs.‘R2’4.5 (1%-9%)], length of stay[‘R1’ (4±3.9) days vs. ‘R2’ (5.57±8.55) days], need and duration of mechanical ventilation [‘R1’ (9.52%) for(2.3±7.6) days vs. ‘R2’ (23.81%) for(6.4±1.4) days] in 2nd admission.
Conclusion: Readmitted patients had increased morbidity in their readmission period; post operative complications and sepsis were the main readmission causes and SWIFT score revealed poor performance. The SWIFT score could therefore be used for risk prediction for readmission at ICU discharge if cutoff value is lowered to ≥12 (which showed higher readmission frequency than cutoff value ≥15).