Characteristics and Outcome of ICU Unplanned Readmission in Trauma Patients During the Same Hospitalization

Abstract

Objective: This study aimed to determine the rate of readmission for trauma patients in ICUs, as well as thefactors that predict this outcome.Methods: This retrospective cohort study was conducted at Emtiaz Hospital, a level I referral trauma center(Shiraz, Iran). It analyzed the ICU readmission rates among trauma patients over three years. The requireddata were extracted from the Iranian Intensive Care Registry (IICUR), which included patient demographics,injury severity, physiological parameters, and clinical outcomes. Statistical analysis was performed using SPSSversion 25.0. Descriptive statistics and different statistical tests, such as T-tests, Mann-Whitney tests, Chisquare tests, and logistic binary regression test were utilized.Results: Among the 5273 patients discharged from the ICU during the study period, 195 (3.7%) were readmittedduring the same hospitalization. Patients readmitted to the ICU had a significantly higher mean age (54.83±22.73years) than those who were not readmitted (47.08 years, p<0.001). Lower Glasgow Coma Scale (GCS) scoresat admission and discharge were associated with ICU readmission, implying that neurological status andreadmission risk were correlated with each other. Furthermore, respiratory challenges were identified as theleading cause of unexpected readmission, including respiratory failure, hypoxic respiratory failure, respiratorydistress, and respiratory infections such as pneumonia. Injury patterns analysis revealed a higher frequency ofpoly-trauma and head and neck injuries among patients readmitted to the ICU.Conclusion: This study underscored the importance of ICU readmission among trauma patients, with a highreadmission rate during the same hospitalization. By developing comprehensive guidelines and optimizingdischarge processes, healthcare providers could potentially mitigate ICU readmissions and associatedcomplications, ultimately enhancing patient outcomes and resource utilization in trauma ICU settings. Thisresearch provided valuable insights to inform evidence-based practices and improve the quality of care deliveryfor trauma patients in intensive care settings.

Keywords

• trauma
• readmission
• intensive care unit
• predictor
• prognosis