Discharge decision-making in a medical ICU: characteristics of unexpected readmissions.
To identify those patients most likely to be readmitted to a Medical ICU (MICU), we studied 512 MICU admissions during a 1-yr period. There were 36 readmissions within the same hospitalization in that interval. When ICU deaths and short-term drug overdoses were excluded, these 36 readmissions comprised 12% of all patients discharged from MICU. The mortality rate of this group was 58%, greater than twice the overall mortality rate for the year. Fifty-three % of the patients were readmitted because of recurrence of their initial disease on admission, with septicemia being the most common disease. Another 30% were readmitted because of a new complication, one-half of which were medication toxicities. We have attempted to delineate diseases, medications, and complications which may predict the high-risk discharge from MICU. Further studies to identify high-risk and low-risk admissions and discharges will effect better use of intensive care.
D003657:Decision Making; D005260:Female; D006746:Hospital Bed Capacity, 500 and over; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009820:Ohio; D010351:Patient Discharge; D010359:Patient Readmission; D012008:Recurrence