Admission factors associated with intensive care unit readmission in critically ill oncohematological patients: a retrospective cohort study.
OBJECTIVE
The purpose of our study was to determine the admission factors associated with intensive care unit readmission among oncohematological patients.


METHODS
Retrospective cohort study using an intensive care unit database from a tertiary oncological center. The participants included 1,872 critically ill oncohematological patients who were admitted to the intensive care unit from January 2012 to December 2014 and who were subsequently discharged alive. We used univariate and multivariate analysis to identify the admission risk factors associated with later intensive care unit readmission.


RESULTS
One hundred seventy-two patients (9.2% of 1,872 oncohematological patients discharged alive from the intensive care unit) were readmitted after intensive care unit discharge. The readmitted patients were sicker compared with the non-readmitted group and had higher hospital mortality (32.6% versus 3.7%, respectively; p < 0.001). In the multivariate analysis, the independent risk factors for intensive care unit readmission were male sex (OR: 1.5, 95% CI: 1.07 - 2.12; p = 0.019), emergency surgery as the admission reason (OR: 2.91, 95%CI: 1.53 - 5.54; p = 0.001), longer hospital length of stay before intensive care unit transfer (OR: 1.02, 95%CI: 1.007 - 1.035; p = 0.003), and mechanical ventilation (OR: 2.31, 95%CI: 1.57 - 3.40; p < 0.001).


CONCLUSIONS
In this cohort of oncohematological patients, we identified some risk factors associated with intensive care unit readmission, most of which are not amenable to interventions. The identification of risk factors at intensive care unit discharge might be a promising approach.
Instituto de Ensino e Pesquisa, Hospital Sírio-Libanês, São Paulo, SP, Brazil.
Cinthia Mendes
CM
Rodrigues
Instituto de Ensino e Pesquisa, Hospital Sírio-Libanês, São Paulo, SP, Brazil.
Ellen Maria Campos
EM
Pires
Instituto de Ensino e Pesquisa, Hospital Sírio-Libanês, São Paulo, SP, Brazil.
Jorge Patrick Oliveira
JP
Feliciano
Instituto de Ensino e Pesquisa, Hospital Sírio-Libanês, São Paulo, SP, Brazil.
Jose Mauro
JM
Vieira
Instituto de Ensino e Pesquisa, Hospital Sírio-Libanês, São Paulo, SP, Brazil.
Leandro Utino
LU
Taniguchi
D000368:Aged; D015331:Cohort Studies; D016638:Critical Illness; D005260:Female; D019337:Hematologic Neoplasms / Q000628:therapy*; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors