• Rev Bras Ter Intensiva · Dec 2009

    Early predictive factors for intensive care unit readmission.

    • André Miguel Japiassú, Michel Schatkin Cukier, Ana Gabriela Coelho de Magalhães Queiroz, Carlos Roberto Naegeli Gondim, Guilherme Loures de Araújo Penna, Gustavo Ferreira Almeida, Pedro Martins Pereira Kurtz, André Salgado Rodrigues, Márcia Barbosa de Freitas, Ronaldo Vegni E Souza, Paula Araújo Rosa, Clovis Jean da Cruz Faria, Luis Eduardo Fonseca Drumond, Marcelo Kalichsztein, and Gustavo Freitas Nobre.
    • Unidade de Tratamento Intensivo, Casa de Saúde São José, Rio de Janeiro, RJ, Brasil.
    • Rev Bras Ter Intensiva. 2009 Dec 1; 21 (4): 353-8.

    ObjectiveTo predict readmission in intensive care unit analyzing the first 24 hours data after intensive care unit admission.MethodsThe 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.ResultsFive 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.ConclusionAge, comorbidities and respiratory- and/or sepsis-related admission are associated with increased readmission risk in the studied sample.

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