The Risk and Related Factors for Readmission to an ICU Within 7 Days in Mechanically Ventilated Subjects—A Nationwide Population-Based Cohort Study
| Autor: | Chia-Chen Chu, Yuh-Show Tsai, Chin-Jung Liu, Pei-Tseng Kung, Wen-Chen Tsai, Chuen Ming Shih |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Pediatrics medicine.medical_specialty Time Factors Adolescent Taiwan Comorbidity Critical Care and Intensive Care Medicine Logistic regression Patient Readmission Young Adult Sex Factors Risk Factors medicine Humans Young adult Generalized estimating equation Aged Retrospective Studies Aged 80 and over business.industry Age Factors Retrospective cohort study General Medicine Length of Stay Middle Aged medicine.disease Respiration Artificial Patient Discharge Pulmonary embolism Intensive Care Units Logistic Models Pneumothorax Emergency medicine Female business Respiratory care |
| Zdroj: | Respiratory Care. 60:1786-1795 |
| ISSN: | 1943-3654 0020-1324 |
| DOI: | 10.4187/respcare.03868 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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