Risk factors and associated outcomes of respiratory ICU readmission

Abstract

Background and objectives: The results of readmitted patients to the respiratory intensive care unit (ICU) are usually negative and include longer hospital and ICU stays, higher rates of morbidity and mortality. Patient variables like age, co-morbidities and disease severity may all be risk factors for ICU readmission and in-hospital death following ICU discharge. The aim of the study is to determine the impact of respiratory ICU readmission on patient outcomes and to assess the efficacy of a risk stratification tool for respiratory ICU readmissions prediction. Methods: Prospective cohort study involving 107 patients who will be admitted to the respiratory intensive care unit of chest diseases department at Kasr Al Ainy hospital, Cairo University from 1st of July 2023 to the end of December 2023. During their first admission, all patients underwent a complete clinical history, clinical examination, full labs, the Sequential Organ Failure Assessment (SOFA) score and the Acute Physiology And Chronic Health Evaluation (APACHE II) score. Results: Throughout the study period, 18 patients (16.8%) required readmission to the respiratory ICU. During first admission 15 out of 107 patients died (14%). 5 of the 18 patients who required readmissions died (27.8%). A statistically significant difference was observed in the incidence of diabetes mellitus (P value 0.018), the SOFA score (P value 0.009) and the APACHE II score (P value 0.014) at admission between the groups who were readmitted and those who were not. Conclusion: Respiratory ICU readmissions were common and related to bad outcomes. Diabetes mellitus and higher SOFA and APACHE II scores are risk factors to readmission.