A model to predict short-term death or readmission after intensive care unit discharge.

Age Factors; Aged; Health Status Indicators; Hospital Mortality; Humans; Intensive Care Units/statistics & numerical data; Length of Stay/statistics & numerical data; Middle Aged; Patient Readmission/statistics & numerical data; Prognosis; Retrospective Studies; Risk Factors

Abstract :

[en] OBJECTIVE: Early 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. DESIGN: Retrospective analysis of a prospective database was done. SETTING: Four ICUs of the French Outcomerea network participated. PATIENTS: Patients were consecutive adults with ICU stay longer than 24 hours who were discharged alive to same-hospital wards without treatment-limitation decisions. MAIN RESULTS: Of 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). CONCLUSION: Among 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.

Disciplines :

Anesthesia & intensive care

Author, co-author :

Ouanes, Islem

Schwebel, Carole

Francais, Adrien

Bruel, Cedric

Philippart, Francois

Vesin, Aurelien

Soufir, Lilia

Adrie, Christophe

Garrouste-Orgeas, Maite

Timsit, Jean-Francois

Misset, Benoît ; Centre Hospitalier Universitaire de Liège - CHU > Autres Services Médicaux > Service des soins intensifs

Language :

English

Title :

A model to predict short-term death or readmission after intensive care unit discharge.

Publication date :

2012

Journal title :

Journal of Critical Care

ISSN :

0883-9441

eISSN :

1557-8615

Publisher :

W. B. Saunders Co., United Kingdom

Volume :

Issue :

Pages :

422.e1-9

Peer reviewed :

Peer Reviewed verified by ORBi

Commentary :

Available on ORBi :

since 21 February 2020

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