Early predictive factors for intensive care unit readmission - Critical Care Science (CCS)

OBJECTIVE: To predict readmission in intensive care unit analyzing the first 24 hours data after intensive care unit admission. METHODS: The first intensive care unit admission of patients was analyzed from January to May 2009 in a mixed unit. Readmission to the unit was considered those during the same hospital stay or within 3 months after intensive care unit discharge. Deaths during the first admission were excluded. Demographic data, use of mechanical ventilation, and report of stay longer than 3 days were submitted to uni and multivariate analysis for readmission. RESULTS: Five hundred seventy-seven patients were included (33 excluded deaths). The readmission group had 59 patients, while 518 patients were not readmitted. The lead time between the index admission and readmission was 9 (3-28) days (18 were readmitted in less than 3 days), and 10 died. Patients readmitted at least once to the intensive care unit had the differences below in comparison to the control group: older age: 75 (67-81) versus 67 (56-78) years, P<0.01; admission for respiratory insufficiency or sepsis: 33 versus 13%, P<0.01; medical admission: 49 versus 32%, P<0.05; higher SAPS II score: 27 (21-35) versus 23 (18-29) points, P<0.01; Charlson index: 2 (1-2) versus 1 (0-2) points, P<0.01; first ICU stay longer than 3 days: 35 versus 23%, P<0.01. After logistic regression, higher age, Charlson index and admission for respiratory and sepsis were independently associated to readmissions in intensive care unit. CONCLUSION: Age, comorbidities and respiratory- and/or sepsis-related admission are associated with increased readmission risk in the studied sample.