TITLE

Analysis of Causes and Prevention of Early Readmission to Surgical Intensive Care

AUTHOR(S)
Nishi, Gregg K.; Suh, Richard H.; Wilson, Matthew T.; Cunneen, Scott A.; Margulies, Daniel R.; Shabot, M. Michael
PUB. DATE
October 2003
SOURCE
American Surgeon;Oct2003, Vol. 69 Issue 10, p913
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
The purpose of this study was to analyze causes of early readmission to the surgical intensive care unit (SICU), to determine whether readmission can be predicted or prevented, and to compare outcomes of patients readmitted to the SICU with patients not requiring readmission. Ail patients admitted to the Cedars-Sinai SICU from January 1, 1996, to December 31, 2001, were included. Clinical data was prospectively collected in an on-line computer system. The charts of all early readmission patients were retrospectively reviewed. SICU and hospital outcomes were abstracted from a computerized data warehouse. During the study period, 10,840 patients were admitted to the SICU including 97 (0.89%) early readmissions. SICU admission APACHE II and SAPS I scores, SICU and hospital length of stay, and mortality were significantly higher in readmitted patients compared to patients not requiring readmission. The majority of early SICU readmissions were due to respiratory and neurologic deterioration. Upon review, 62 per cent of all readmissions met appropriate SICU discharge criteria and were not predictable while only 5 per cent of SICU discharge were felt to have been premature. Patient outcomes are adversely affected by early readmission to the SICU. Careful neurologic assessment, meticulous attention to respiratory care transfer orders, and prompt respiratory therapy on floor care may significantly decrease the need for early readmission to the SICU.
ACCESSION #
11855824

 

Related Articles

  • Ward mortality in patients discharged from the ICU with tracheostomy may depend on patient’s vulnerability. Fernandez, Rafael; Bacelar, Nestor; Hernandez, Gonzalo; Tubau, Isabel; Baigorri, Francisco; Gili, Gisela; Artigas, Antonio // Intensive Care Medicine;Oct2008, Vol. 34 Issue 10, p1878 

    To determine the effect of discharge from the ICU with a tracheostomy tube on ward mortality and its relation to patient vulnerability. Retrospective single-center cohort study. Database (2003–2006) review of patients undergoing mechanical ventilation (MV) > 24 h and discharged from the...

  • Recovery from intensive care. Griffiths, Richard D.; Jones, Christina // BMJ: British Medical Journal (International Edition);08/14/99, Vol. 319 Issue 7207, p427 

    Addresses patient recovery from intensive care. Examples of physical disorders after intensive care; Problems experienced by patients; Rehabilitation after critical illness; Guide to care after hospital discharge.

  • A strategy to enhance the safety and efficiency of handovers of ICU patients: study protocol of the pICUp study. Sluisveld, Nelleke van; Zegers, Marieke; Westert, Gert; Van der Hoeven, Johannes Gerardus; Wollersheim, Hub // Implementation Science;2013, Vol. 8 Issue 1, p1 

    Background: To use intensive care unit (ICU) facilities efficiently and ensure high quality of care, an optimal patient flow is necessary. Discharging patients relieves the pressure on ICU beds but the risk of premature discharge must be managed carefully. Suboptimal patient discharge may result...

  • Çocuk yoÄŸun bakım birimlerine yatırılma ve taburcu edilme ælçütleri. Demirkol, Demet; Karaböcüoğlu, Metin // Turkish Pediatrics Archive / Turk Pediatri Arsivi;jun2010, Vol. 45 Issue 2, p82 

    These guidelines were summarized to provide a reference for preparing policies on admission and discharge for pediatric intensive care units. By using this document as a framework for multidisciplinary admission and discharge policies, utilization of pediatric intensive care units can be...

  • Informed consent for research in ICU obtained before ICU admission. Chenaud, Catherine; Merlani, Paolo; Ricou, Bara // Intensive Care Medicine;Mar2006, Vol. 32 Issue 3, p439 

    Objective: To analyze the procedure of the informed consent for ICU research obtained before ICU admission.Design: Prospective, open, observational study.Setting: 20-bed surgical ICU of a tertiary teaching university hospital and the ward before and after...

  • Considerations and proposals for the management of patients after prolonged intensive care unit admission. Robin H Johns // Postgraduate Medical Journal;Sep2010, Vol. 86 Issue 1019, p541 

    The majority of patients admitted to the intensive care unit (ICU) have a short stay of only a few days. However a small but significant number require prolonged intensive care. This is typically due to persisting, and sometimes complex, medical/surgical problems. Discharge of such ICU patients...

  • The critically ill patient: making the referral to intensive care. Elnour, Shaima; Shankar-Hari, Manu // British Journal of Hospital Medicine (17508460);Oct2011, Vol. 72 Issue 10, pM154 

    The article discusses the need to refer critically ill patients, i.e. those in need of level 2 to 3 care and priority 1 to 2 admissions, to the intensive care unit (ICU). The 2000 Department of Health (DH) report "Comprehensive Critical Care" is mentioned, and the criteria for admission to the...

  • Application of the Sequential Organ Failure Assessment (SOFA) Score to Bacteremic ICU Patients. Routsi, C.; Pratikaki, M.; Sotiropoulou, C.; Platsouka, E.; Markaki, V.; Paniara, O.; Vincent, J.-L.; Roussoss, C. // Infection;Aug2007, Vol. 35 Issue 4, p240 

    Patients admitted to intensive care units (ICUs) are at a high risk of acquiring blood stream infections. We examined whether SOFA score on ICU admission and on the day of bacteremia can predict the occurrence of bacteremia and the outcome of bacteremic ICU patients. All patients admitted to a...

  • Mortality related to after-hours discharge from intensive care in Australia and New Zealand, 2005-2012. Gantner, Dashiell; Farley, KJ; Bailey, Michael; Huckson, Sue; Hicks, Peter; Pilcher, David // Intensive Care Medicine;Oct2014, Vol. 40 Issue 10, p1528 

    Introduction: After-hours discharge from the intensive care unit (ICU) is associated with adverse patient outcomes including increased ICU readmissions and mortality. Since Australian and New Zealand data were last published, overall ICU patient mortality has decreased; however it is unknown...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics