Readmissions to General ICUs in a Geographic Area of Poland Are Seemingly Associated with Better Outcomes

Marek Grochla, Wojciech Saucha, Daniel Ciesla and Piotr Knapik
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Marek Grochla: Department of Anaesthesiology, Intensive Therapy and Emergency Medicine, Silesian Centre for Heart Diseases, Medical University of Silesia, 41-800 Zabrze, Poland
Wojciech Saucha: Department of Science, Education and New Medical Technologies, Silesian Centre for Heart Diseases, 41-800 Zabrze, Poland
Daniel Ciesla: Department of Science, Education and New Medical Technologies, Silesian Centre for Heart Diseases, 41-800 Zabrze, Poland
Piotr Knapik: Department of Anaesthesiology, Intensive Therapy and Emergency Medicine, Silesian Centre for Heart Diseases, Medical University of Silesia, 41-800 Zabrze, Poland

IJERPH, 2020, vol. 17, issue 2, 1-11

Abstract: Background: Various factors can contribute to high mortality rates in intensive care units (ICUs). Here, we intended to define a population of patients readmitted to general ICUs in Poland and to identify independent predictors of ICU readmission. Methods: Data derived from adult ICU admissions from the Silesian region of Poland were analyzed. First-time ICU readmissions (≤30 days from ICU discharge after index admissions) were compared with first-time ICU admissions. Pre-admission and admission variables that independently influenced the need for ICU readmission were identified. Results: Among the 21,495 ICU admissions, 839 were first-time readmissions (3.9%). Patients readmitted to the ICU had lower mean APACHE II (21.2 ± 8.0 vs. 23.2 ± 8.8, p < 0.001) and TISS-28 scores (33.7 ± 7.4 vs. 35.2 ± 7.8, p < 0.001) in the initial 24 h following ICU admission, compared to first-time admissions. ICU readmissions were associated with lower mortality vs. first-time admissions (39.2% vs. 44.3%, p = 0.004). Independent predictors for ICU readmission included the admission from a surgical ward (among admission sources), chronic respiratory failure, cachexia, previous stroke, chronic neurological diseases (among co-morbidities), and multiple trauma or infection (among primary reasons for ICU admission). Conclusions: High mortality associated with first-time ICU admissions is associated with a lower mortality rate during ICU readmissions.

Keywords: ICU; admission; readmission; mortality (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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