title: The Risk and Related Factors for Readmission to an ICU Within 7 Days in Mechanically Ventilated Subjects--A Nationwide Population-Based Cohort Study.
abstract: BACKGROUND
  Readmission of mechanically ventilated patients to an ICU within 7 d reflects not only patient safety but also the quality of care of the ICU. This study aimed to investigate the risk and related factors for readmission to an ICU within 7 d in mechanically ventilated subjects.
  
  
  METHODS
  A total of 658,452 mechanically ventilated subjects discharged from an ICU whose age was ≥ 17 y old were obtained from the Taiwan National Health Insurance Research Database for the period from January 1, 2005, to December 31, 2011. The study applied a generalized estimating equation logistic regression model to explore whether the mechanically ventilated subjects were readmitted within 7 d or not and the related factors.
  
  
  RESULTS
  A total of 29,657 subjects were readmitted to the ICU within 7 d; the total readmission rate was 4.5%. Also, 64.8% of the subjects with the same diagnosis were returned to the ICU within 7 d. Generalized estimating equation logistic regression model results showed that the factors related to higher risk of readmission were male sex, old age, higher comorbidity score, complications (eg, pneumothorax, subcutaneous emphysema, pneumonia, oxygen toxicity, pulmonary embolism, or pulmonary edema), use of a private hospital ICU, ICU stay ≥21 d, transfer to a respiratory care center and respiratory care ward, and subsequent transfer to the regional hospital or district hospital.
  
  
  CONCLUSIONS
  The risk and related factors of a mechanically ventilated subject whose age is ≥ 17 y old being readmitted to the ICU within 7 d include subject characteristics, health status, hospital attributes, and the length of ICU stay. Therefore, higher risk subjects should receive attention and assessment before transfer or discharge from the ICU to prevent readmission.
authors.affiliation: Department of Respiratory Therapy Department of Respiratory Therapy Department of Biomedical Engineering, Chung-Yuan Christian University, Jhongli, Taiwan.
authors.forename: Chia-Chen
authors.initials: CC
authors.lastname: Chu
authors.affiliation: Department of Respiratory Therapy Department of Respiratory Therapy.
authors.forename: Chin-Jung
authors.initials: CJ
authors.lastname: Liu
authors.affiliation: Department of Respiratory Therapy Division of Pulmonary and Critical Care Medicine, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Chuen-Ming
authors.initials: CM
authors.lastname: Shih
authors.affiliation: Department of Healthcare Administration, Asia University, Taichung, Taiwan.
authors.forename: Pei-Tseng
authors.initials: PT
authors.lastname: Kung
authors.affiliation: Department of Biomedical Engineering, Chung-Yuan Christian University, Jhongli, Taiwan.
authors.forename: Yuh-Show
authors.initials: YS
authors.lastname: Tsai
authors.affiliation: Department of Health Services Administration, China Medical University, Taichung, Taiwan. wtsai@mail.cmu.edu.tw.
authors.forename: Wen-Chen
authors.initials: WC
authors.lastname: Tsai
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012121:Respiration, Artificial / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013624:Taiwan; D013997:Time Factors; D055815:Young Adult
keywords: ICU readmission; intensive care unit (ICU); mechanically ventilated subjects; respiratory care center; respiratory care ward