• Carole Schwebel, Maïté Garrouste-Orgeas, Christophe Adrie, Aurélien Vesin, Islem Ouanes, Outcomerea Study Group, Adrien Français, and Lilia Soufir.
• Intensive Care Unit, Saint-Joseph Hospital, Paris, France.
• J Crit Care. 2012 Aug 1;27(4):422.e1-9.

ObjectiveEarly unplanned readmission to the intensive care unit (ICU) carries a poor prognosis, and post-ICU mortality may be related, in part, to premature ICU discharge. Our objectives were to identify independent risk factors for early post-ICU readmission or death and to construct a prediction model.DesignRetrospective analysis of a prospective database was done.SettingFour ICUs of the French Outcomerea network participated.PatientsPatients were consecutive adults with ICU stay longer than 24 hours who were discharged alive to same-hospital wards without treatment-limitation decisions.Main ResultsOf 5014 admitted patients, 3462 met our inclusion criteria. Age was 60.6 ± 17.6 years, and admission Simplified Acute Physiology Score II (SAPS II) was 35.1 ± 15.1. The rate of death or ICU readmission within 7 days after ICU discharge was 3.0%. Independent risk factors for this outcome were age, SAPS II at ICU admission, use of a central venous catheter in the ICU, Sepsis-related Organ Failure Assessment and Systemic Inflammatory Response Syndrome scores before ICU discharge, and discharge at night. The predictive model based on these variables showed good calibration. Compared with SAPS II at admission or Stability and Workload Index for Transfer at discharge, discrimination was better with our model (area under receiver operating characteristics curve, 0.74; 95% confidence interval, 0.68-0.79).ConclusionAmong patients without treatment-limitation decisions and discharged alive from the ICU, 3.0% died or were readmitted within 7 days. Independent risk factors were indicators of patients' severity and discharge at night. Our prediction model should be evaluated in other ICU populations.Copyright © 2012 Elsevier Inc. All rights reserved.

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