Revised Acute Physiology and Chronic Health Evaluation score as a predictor of neurosurgery intensive care unit readmission: a case-controlled study.
OBJECTIVE
Patients with neurologic system problems are among the most common patients readmitted to the intensive care unit (ICU). Readmission predictors for neurologic ICU patients have not been established. Previous research suggests that the Revised Acute Physiology and Chronic Health Evaluation (APACHE II) score is one indication of the critical status of ICU-admitted patients; however, the ability of the discharge APACHE II to predict readmission to the ICU requires further study. The purpose of this study was to investigate the ability of the APACHE II scoring system to predict ICU readmission of neurosurgical and ICU patients.


METHODS
A retrospective case-controlled comparison study and a review of patient records for all patients admitted to 8 ICUs from January 2003 to June 2005 (N = 753) were conducted. Readmitted neurosurgery ICU patients were matched with 58 randomly selected nonreadmitted patients.


RESULTS
Nine variables were significantly different between the readmission and case-controlled group. The APACHE II discharge score was the only significant predictor and was able to predict 18.6% of neurologic ICU readmissions. The risk of ICU readmission increased when the APACHE II score at the time of discharge exceeded 8.5 points.


CONCLUSIONS
The risk of ICU readmission of neurologic ICU patients can be predicted by determining APACHE II score upon ICU discharge.
Lee
Huan Fang
HF
Department of Nursing and Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan City (701), Taiwan.
Lin
Shu-Ching
SC
Lu
Chin-Li
CL
Chen
Chiao Fang
CF
Yen
Miaofen
M
D018806:APACHE; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000145:classification*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012306:Risk