Abstract
BACKGROUND: Readmission of mechanically ventilated patients to an ICU within 7 d reflects not only patient safety but also the quality of care of the ICU. This study aimed to investigate the risk and related factors for readmission to an ICU within 7 d in mechanically ventilated subjects.
METHODS: A total of 658,452 mechanically ventilated subjects discharged from an ICU whose age was ≥ 17 y old were obtained from the Taiwan National Health Insurance Research Database for the period from January 1, 2005, to December 31, 2011. The study applied a generalized estimating equation logistic regression model to explore whether the mechanically ventilated subjects were readmitted within 7 d or not and the related factors.
RESULTS: A total of 29,657 subjects were readmitted to the ICU within 7 d; the total readmission rate was 4.5%. Also, 64.8% of the subjects with the same diagnosis were returned to the ICU within 7 d. Generalized estimating equation logistic regression model results showed that the factors related to higher risk of readmission were male sex, old age, higher comorbidity score, complications (eg, pneumothorax, subcutaneous emphysema, pneumonia, oxygen toxicity, pulmonary embolism, or pulmonary edema), use of a private hospital ICU, ICU stay ≥21 d, transfer to a respiratory care center and respiratory care ward, and subsequent transfer to the regional hospital or district hospital.
CONCLUSIONS: The risk and related factors of a mechanically ventilated subject whose age is ≥ 17 y old being readmitted to the ICU within 7 d include subject characteristics, health status, hospital attributes, and the length of ICU stay. Therefore, higher risk subjects should receive attention and assessment before transfer or discharge from the ICU to prevent readmission.
- mechanically ventilated subjects
- intensive care unit (ICU)
- ICU readmission
- respiratory care center
- respiratory care ward
Footnotes
- Correspondence: Wen-Chen Tsai DrPH, China Medical University, 91 Hsueh-Shih Road, 40402 Taichung, Taiwan. E-mail: wtsai{at}mail.cmu.edu.tw.
Mr Chu presented a version of this paper at the American Association for Respiratory Care Congress 2014, held December 9–12, 2014, in Las Vegas, Nevada.
Supplementary material related to this paper is available at http://www.rcjournal.com.
This study is based in part on data from the Taiwan National Health Insurance Research Database provided by the National Health Insurance Administration, Ministry of Health and Welfare and managed by National Health Research Institutes. The interpretation and conclusions contained herein do not represent those of the National Health Insurance Administration, Ministry of Health and Welfare, or National Health Research Institutes. This study was supported by China Medical University Hospital Grant DMR-103-009 and Taiwan Department of Health Clinical Trial and Research Center of Excellence Grant DOH101-TD-B-111-004. The authors have disclosed no conflicts of interest.
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