Study reveals patterns of readmissions to the intensive care unit
Patients readmitted to the intensive care unit (ICU) have higher death rates, higher costs, and longer hospital stays than those not readmitted to the ICU, reveals a new study. The national study of 196,202 ICU readmissions in the United States found that 2 percent of patients were readmitted to the ICU within 48 hours, 3.7 percent within 120 hours, and 5.4 percent within 21 days of discharge. Comparing never-readmitted patients with those readmitted within 48 hours, 3.7 percent vs. 20.7 percent died in the hospital after ICU discharge, 64.4 percent vs. 36.6 percent were discharged home, and median hospital length of stay was 8 versus 15 days, respectively.
Neither 48- nor 120-hour readmission rates varied across patient or ICU types, and ICU readmission rates did not change from 2001 to 2007. The researchers caution that their study does not settle the important questions of whether readmissions are preventable or causally related to poor outcomes. Too many readmissions could suggest the occurrence of preventable adverse events, but some readmissions may be inevitable, and others may even benefit patients.
The researchers conclude that any use of ICU readmissions as a metric for quality of care must be accompanied by mortality and length-of-stay metrics. Their study was supported in part by the Agency for Healthcare Research and Quality (HS18406).
See "The epidemiology of intensive care unit readmissions in the United States," by Sydney E.S. Brown, B.A., Sarah J. Ratcliffe, Ph.D., Jeremy M. Kahn, M.D., and Scott D. Halpern, M.D., in the May 1, 2012, American Journal of Respiratory Critical Care Medicine 185(9), pp. 955-964.
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