중환자실 재입실 환자의 임상 예후

Abstract

Background: The government has attempted to control the cost of health care. However, this policy can increase the number of premature discharges from the intensive care unit (ICU), which will then increase readmission rate to the ICU. Readmission to the ICU during the same hospital stay has been identified as a quality indicator. The aim of this study was to determine the clinical features and outcome of patients readmitted to the ICU during the same hospital stay.

Methods: For this study, reviewed the data from all patients admitted to the ICU between July 1, 2000 and Jun 30, 2001 were retrospectively analyzed. The data in this study included the patient demographics, hospital and ICU admission date, the diagnosis on ICU admission, co-morbid disease of the patients, Acute Physiology and Chronic Health Evaluation (APACHE) II scores on the ICU admission, the lengths of the ICU stay, the hospital days, and the patients´ outcomes on hospital discharge. The reason for readmission was classified as either a recurrence of the initial disease or an occurrence of new complications, and the non-survivors and survivors after readmission to the ICU were compared.

Results: The readmission rate was 7.5% and the mortality rate of the readmitted patients was 66%. The age, gender, the severity score at admission, and disease distributions were not significantly different between the readmitted patients and the non-readmitted patients. However, the lengths of the ICU stay and hospital days of the readmitted patients were significantly longer than those of the non-readmitted patients.

Conclusion: Patients requiring ICU readmission during the same hospital stay had higher hospital mortality rates than the patients discharged from the ICU who did not require a subsequent readmission.