Characteristics and Outcomes of Patients Readmitted to The Medical Intensive Care Unit: A Retrospective Study in a Tertiary Hospital in Taiwan

Abstract

Summary: Background: This study aimed to evaluate outcomes of patients and the difference between geriatric and young patients readmitted to the medical intensive care unit. Methods: From January 1, 2011 to December 31, 2013, 117 medical ICU readmissions were included. Results: The study population had a mean Charlson comorbidity score of 7.2 and stayed 12.3 days in the ward before ICU readmission. The most common cause for readmission was respiratory disease in 49 (41.9%) patients, and the average readmission duration was 10.1 days. There were 74 patients (63.2%) who survived. Among the survivors, only 50 were discharged from the hospital. The overall mean duration of hospital stay was 51.5 days. Those who survived the hospital course were younger (64.1 vs. 75.6 years) and had a higher coma score (10.2 vs. 7.5), lower Charlson score (6.4 vs. 8.6), and lower APACHE II score (24.4 vs. 31.3) (p < 0.05). Compared with older patients, younger patients had lower scores on readmission (APACHE II: 24.9 vs. 31.2 and Charlson score: 5.4 vs. 8.3) and had less probabilities of receiving mechanical ventilation (p < 0.05). Although there was no difference between the groups in the durations of ward stay and ICU readmission as well as in the outcome, the younger patients had a better chance of hospital survival (p < 0.05). Conclusion: Readmitted ICU patients, especially the geriatric group, had a very poor prognosis. The worsened APACHE score might be a good predictor for readmission survival. The Charlson score was an important hospital survival predictor. Keywords: intensive care unit, readmission outcome