title: Patients' characteristics associated with readmission to a surgical intensive care unit.
abstract: BACKGROUND
  Readmission within 48 hours is a leading performance indicator of the quality of care in an intensive care unit.
  
  
  OBJECTIVE
  To investigate variables that might be associated with readmission to a surgical intensive care unit.
  
  
  METHODS
  Demographic characteristics, severity-of-illness scores, and survival rates were collected for all patients admitted to a surgical intensive care unit between 1995 and 2000. Long-term survival and quality of life were determined for patients who were readmitted within 30 days after discharge from the unit. Quality of life was measured with the EuroQol-6D questionnaire. Multivariate logistic analysis was used to calculate the independent association of expected covariates.
  
  
  RESULTS
  Mean follow-up time was 8 years. Of the 1682 patients alive at discharge, 141 (8%) were readmitted. The main causes of readmission were respiratory decompensation (48%) and cardiac conditions (16%). Compared with the total sample, patients readmitted were older, mostly had vascular (39%) or gastrointestinal (26%) disease, and had significantly higher initial severity of illness (P = .003, .007) and significantly more comorbid conditions (P = .005). For all surgical classifications except general surgery, readmission was independently associated with type of admission and need for mechanical ventilation. Long-term mortality was higher among patients who were readmitted than among the total sample. Nevertheless, quality-of-life scores were the same for patients who were readmitted and patients who were not.
  
  
  CONCLUSIONS
  The adverse effect of readmission to the intensive care unit on survival appears to be long-lasting, and predictors of readmission are scarce.
authors.affiliation: Department of Surgery, University Medical Centre Utrecht, the Netherlands. tk.timmers@gmail.com
authors.forename: T K
authors.initials: TK
authors.lastname: Timmers
authors.forename: M H J
authors.initials: MH
authors.lastname: Verhofstad
authors.forename: K G M
authors.initials: KG
authors.lastname: Moons
authors.forename: L P H
authors.initials: LP
authors.lastname: Leenen
mesh_terms: D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology; D006331:Heart Diseases / Q000453:epidemiology; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D009426:Netherlands / Q000453:epidemiology; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D011788:Quality of Life; D012086:Reoperation; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000453:epidemiology; D018805:Sepsis / Q000453:epidemiology; D012720:Severity of Illness Index; D014652:Vascular Diseases / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology