title: Characteristics of patients readmitted to intensive care unit: a nested case-control study.
abstract: OBJECTIVE
  To evaluate the pattern of unplanned readmissions to the intensive care unit and identify patients at risk of readmission.
  
  
  METHODS
  Nested case-referent study.
  
  
  METHODS
  Tertiary hospital, Hong Kong.
  
  
  METHODS
  A total of 146 patients with unplanned intensive care unit readmission were compared with 292 control patients who were discharged from the intensive care unit alive and never readmitted. Cases and controls were matched for age, gender, and disease severity.
  
  
  METHODS
  Patient demographics, initial and pre-discharge clinical parameters, reasons for readmission, and outcomes were studied.
  
  
  RESULTS
  During the 30-month study period, the readmission rate was 5.1%. Readmitted patients had significantly higher mortality and longer mean hospital lengths of stay (both P<0.001). Most patients in this cohort (36.3%) were readmitted for a respiratory cause. Based on classification tree analysis, postoperative patients with sepsis (adjusted P=0.043), non-operative septic patients with fluid gain 24 hours pre-discharge (adjusted P=0.013), and non-septic patients with increased sputum quantity on discharge (adjusted P=0.006) were significantly associated with intensive care unit readmission.
  
  
  CONCLUSIONS
  Incomplete resolution of respiratory conditions remained an important reason for potentially preventable intensive care unit readmission. Attention to fluid balance and sputum quantity before intensive care unit discharge might prevent unplanned intensive care unit readmission.
authors: Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
authors: O Y
authors: OY
authors: Tam
authors: Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
authors: S M
authors: SM
authors: Lam
authors: Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
authors: H P
authors: HP
authors: Shum
authors: Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
authors: C W
authors: CW
authors: Lau
authors: Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
authors: Kenny K C
authors: KK
authors: Chan
authors: Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
authors: W W
authors: WW
authors: Yan
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D012307:Risk Factors
keywords: Intensive care units; Patient readmission; Risk factors