Skip to main content
  • Poster presentation
  • Open access
  • Published:

ICU readmission: good or bad?

Introduction

Patients requiring ICU management risk deterioration following discharge. Readmission to the ICU is used as a marker of performance [1] with some controversy [2]. It is established that higher APACHE II scores and longer length of ICU stay are associated with higher risk of ICU readmission [3]. However, there are no criteria available to identify those patients most likely to benefit from readmission [4].

Methods

Prospective data were collected on all patients admitted to a multidisciplinary adult ICU between 2001 and 2009 and entered into a computerised database. This included length of ICU stay, ICU and hospital outcomes, readmission to ICU and days prior to readmission. Data for all ICU admissions were analysed annually.

Results

There were 5,004 patients admitted during 2001 to 2009; 1,315 (26%) were elective postoperative admissions and 3,689 (74%) emergency admissions. The ICU mortality during this period was 15.8% and mean APACHE II score was 17.7 (1 to 55). There were 299 readmissions (6%). The average time between discharge and readmission was 8.5 days (0 to 89) with a mean length of ICU stay of 5.89 days (0.2 to 48.8). The average hospital mortality rate of readmitted patients was 33% and fell from 69% in 2003 to 24% in 2007. The proportion of readmitted patients increased from 3% (11) in 2001 to 10% (68) in 2007. As the proportion of patients readmitted increased, the hospital mortality rates for all ICU admissions fell 10% from 31% in 2001 to 21% in 2009.

Conclusions

As the number of patients readmitted has increased, hospital mortality of both readmitted patients and total ICU patients have fallen. Those readmitted have had a short length of stay (mean 5.89 days).

References

  1. Society of Critical Care Medicine Quality Indicators Committee: Candidate Critical Care Quality Indicators. Anaheim, CA: Society of Critical Care Medicine; 1995.

    Google Scholar 

  2. Cooper GS, et al.: Are readmissions to the intensive care unit a useful measure of hospital performance? Med Care 1999, 37: 399-408.

    Article  CAS  PubMed  Google Scholar 

  3. Chan KS, et al.: Readmission to the intensive care unit: an indicator that reflects the potential risks of morbidity and mortality of surgical patients in the intensive care unit. Surg Today 2009, 39: 295-299.

    Article  PubMed  Google Scholar 

  4. Campbell AJ, et al.: Predicting death and readmission after intensive care discharge. Br J Anaesth 2008, 100: 656-662.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article

Potter, E., Vondra, D., Green, S. et al. ICU readmission: good or bad?. Crit Care 15 (Suppl 1), P461 (2011). https://doi.org/10.1186/cc9881

Download citation

  • Published:

  • DOI: https://doi.org/10.1186/cc9881

Keywords