PURPOSE: Readmission to the intensive care unit (ICU) may be associated with increased ICU and hospital mortality. This has not been examined in mechanically ventilated (MV) patients. This study describes clinical features and outcomes of MV patients readmitted to the ICU.
METHODS: This was a retrospective cohort analysis of patients admitted to a Medical-Surgical ICU requiring MV over a three-year period. Outcomes of patients readmitted and not readmitted were compared. Patients requiring readmission were stratified by time to readmission (<24 hours, 24-72, 72-120 hours and >120 hours).
RESULTS: A total of 2540 patients were admitted to the ICU of which 1945 (76.5%) required MV. Four hundred sixty five (23.8%) MV patients died during the initial ICU stay. Of the 1480 MV discharged from the ICU, 149 (10%) were readmitted. Readmitted and not readmitted MV patients were comparable in terms of baseline demographics and severity of illness. Initial ICU length of stay (LOS) for readmitted and not readmitted patients were also comparable (7.7±8.7 days vs. 7.6 ±10.6 days, p=0.94). There were no clinical predictors for readmission. Hospital mortality was significantly higher for readmitted patients (36.2% vs 6.5% p<0.001, OR 8.1, 95% CI 5.5,12.1), however there were no differences in mortality with time to readmission. Hospital LOS was significantly higher for readmitted patients (44.1±32.6 vs. 18.5 ±19.0 days, p=<0.001).
CONCLUSION: MV patients who require ICU readmission have significantly higher mortality and hospital LOS. Time to readmission does not impact mortality.
CLINICAL IMPLICATIONS: Predicting MV patients at risk for ICU readmission may lead to improved patient outcomes.
DISCLOSURE: Christopher Cook, None.