title: Incidence and predictors of readmission to the cardiac surgery intensive care unit: A retrospective cohort study in Greece.
abstract: BACKGROUND
  Readmission in the intensive care unit (ICU) is a significant morbidity index, which has been related to poor patient outcomes.
  
  
  OBJECTIVE
  To identify the preoperative and intraoperative risk factors for readmission in the cardiac surgery ICU.
  
  
  METHODS
  We conducted a retrospective cohort study of 595 consecutive patients who were admitted to the cardiac surgery ICU of a tertiary hospital of Athens - Greece during the one-year period (September 2011-September 2012). Data collection was carried out, retrospectively, by the use of a short questionnaire and based on the review of medical and nursing patient records at December 2012.
  
  
  RESULTS
  The incidence of ICU readmission was 3.7% (22/595). Respiratory disorders were the main reason for readmission (45.4%). Readmitted patients had a significantly higher in-hospital mortality compared to those requiring no readmission (P < 0.001). Multivariate analysis revealed that female gender [for males odds ratio (OR) 0.37, 95% confidence interval (CI) 0.15-0.89], high logistic EuroSCORE (OR 1.02, 95% CI 1.00-1.04), prolonged cardiopulmonary (CPB) duration (OR 1.01, 95% CI 1.00-1.02) and preoperative renal failure (OR 1.02, 95% CI 1.00-1.05) were the independent risk factors for readmission to the cardiac surgery ICU.
  
  
  CONCLUSIONS
  One intraoperative and three preoperative variables are associated strongly with higher probability for ICU readmission. Shorter CPB duration could contribute to lower ICU readmission incidence. In addition, the early identification of high risk patients for readmission in the cardiac surgery ICU could encourage both the more efficient healthcare planning and resources allocation.
authors.affiliation: Cardiac Surgery ICU, "Evangelismos" General Hospital of Athens, Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Giakoumidakis
authors.affiliation: Cardiac Surgery ICU, "Evangelismos" General Hospital of Athens, Athens, Greece.
authors.forename: Rokeia
authors.initials: R
authors.lastname: Eltheni
authors.affiliation: Department of Anaesthesiology, University Hospital of Heraklion, Crete, Greece.
authors.forename: Athina
authors.initials: A
authors.lastname: Patelarou
authors.affiliation: Cardiothoracic department, Liverpool Heart And Chest Hospital, Liverpool, United Kingdom.
authors.forename: Vasileios
authors.initials: V
authors.lastname: Patris
authors.affiliation: Cardiothoracic department, Liverpool Heart And Chest Hospital, Liverpool, United Kingdom.
authors.forename: Manoj
authors.initials: M
authors.lastname: Kuduvalli
authors.affiliation: Faculty of Nursing, National & Kapodistrian University of Athens, Athens, Greece.
authors.forename: Hero
authors.initials: H
authors.lastname: Brokalaki
keywords: Cardiac surgery; intensive care units; patient readmission