title: [A study on causes of re-admission to surgical intensive care unit and risk factors analysis of their prognosis].
abstract: OBJECTIVE
  To evaluate the causes of readmission of patients to surgical intensive care unit (SICU), and the risk factors involved in their prognosis.
  
  
  METHODS
  Among 7381 SICU patients admitted between January 2009 and February 2012, clinical data of 178 patients readmitted to the SICU were analyzed retrospectively and assessed by univariate and multiple step wise regression analysis.
  
  
  RESULTS
  The SICU readmission rate was 2.41% (178/7381). Among 178 patients readmitted to SICU, 39.89% (71/178) of them were over 70 years old in age, and 46.07% (82/178) of readmission to SICU occurred within 48 hours after their first SICU discharge. The death rate of readmitted patients was 37.08% (66/178). At discharge from SICU and at readmission, the acute physiology and chronic health evaluation II (APACHEII) score in death group (n=66) was higher than that in survivor group (n=112, 9.15±4.13 vs. 7.74±3.62, 18.47±5.67 vs. 12.99±6.32, P<0.05 and P<0.01). At readmission, Glasgow coma score (GCS) was lower than that in survive group (10.88±4.37 vs. 12.37±2.68, P<0.01). Respiratory and operation related complications were the most common causes of SICU readmission. The incidence of sepsis, septic shock and multiple organ dysfunction syndrome(MODS) in death group was obviously higher than that in survivor group (22.7% vs. 7.1%, 19.7% vs. 7.1%, 10.6% to 0 respectively, all P<0.05). The APACHEII score and complicating MODS at time of SICU readmission were found to be the independent risk factors of death as shown by multiple step wise regression analysis (t=5.0163, P=0.0000; t=2.3641, P=0.0192).
  
  
  CONCLUSIONS
  The study indicated that the criteria for discharge of patients from SICU should be strictly controlled in line with patients' condition. It is very important to actively monitor the APACHEII score and GCS score, to control both respiratory and operation related complications in order to reduce the re-admission rate of the patients to SICU.
authors.affiliation: Surgical Intensive Care Unit, People's Hospital of Xinjiang Uygur Autonomous Region, Urumuqi 830001, Xinjiang, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Li
authors.forename: Dong
authors.initials: D
authors.lastname: Chen
authors.forename: Layi
authors.initials: L
authors.lastname: Meike
authors.forename: Xiao-hu
authors.initials: XH
authors.lastname: Ge
authors.forename: Zhi-jie
authors.initials: ZJ
authors.lastname: Xia
mesh_terms: D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000453:epidemiology; D015999:Multivariate Analysis; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult