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Readmission of patients to the intensive care unit – a case-control study

2020; Issue: 80647 Linguagem: Inglês

10.4220/sykepleienf.2020.80647en

1891-2710

Kristin Igland Naustdal, Jorunn Drageset,

Anesthesia and Sedative Agents

Background: International studies show that readmission to the intensive care unit can result in higher mortality rates as well as reducing preparedness and increasing hospital costs.Readmission frequency is documented in Norwegian data registries, but little is known about what transfer characteristics typify readmitted patients. Objective:The objective of the study was 1 to describe who is readmitted to a Norwegian intensive care unit, and 2 to compare transfer characteristics in relation to patients readmitted within 72 hours with patients who were not readmitted.Method: A quantitative study with a case-control design.Data from the Norwegian Intensive Care Registry NIR identified all patients admitted to an intensive care unit at a university hospital in the period from 1 January 2014 to 31 December 2016.Forty-five patients were readmitted within 72 hours.Of these, forty-four patients were compared with a control patient who had been admitted to the same intensive care unit but had not been readmitted.The case control patients were matched according to age, reason for admission, disease severity score, nursing needs score, type of respiratory support and length of stay in the intensive care unit.Logistic regression analysis was used to calculate the odds ratio for readmission according to transfer characteristics. Results:Of 1387 patients admitted during the study period, 105 7.6% were readmitted during the same hospital admission and 45 32% within 72 hours.Readmitted patients are older, but their mortality rate is almost equal to that of non-readmitted patients.The patients readmitted within 72 hours have a significantly higher likelihood of having an incomplete written transfer report (odds ratio OR 5.12, p < 0.001 . Conclusion:Incomplete written transfer reports result in a significantly higher likelihood of readmission.Studies should be conducted with a larger sample in order to shed more light on the findings of the study.The intensive care unit ICU treats the most severely ill patients in the hospital -patients with single or multiple organ failure 1 .Since the treatment requires advanced equipment and drugs as well as continuous monitoring, ICU beds represent an expensive and limited resource 2 .A limited capacity may result in some patients being transferred to a ward prematurely.The assessment is based not only on the patient's medical condition but also on other patients' need for an ICU bed.