Jo et al developed a model with nomogram for predicting the risk of readmission to the medical care unit (MICU). A patient at risk for readmission may benefit from more aggressive management. The authors are from
Patient selection: adult (>= 18 years of age) discharged from medical intensive care unit (MICU), intubated for > 48 hours (excluded if not intubated or if extubated within 48 hours)
Other exclusions: do not resuscitate order, admission following elective surgery, transfer to another ICU in the same hospital
Parameters:
(1) gender
(2) diabetes mellitus
(3) continuous renal replacement therapy (CRRT)
(4) white blood cell count on day of extubation per µL
(5) heart rate just before ICU discharge
points for WBC count =
= MIN(100,(2.5 * ((WBC count) / 1000))
Heart Rate |
Points |
< 50 |
0 |
50 to 140 |
(0.6133 * (heart rate)) - 30.6667 |
> 140 |
55.2 |
Parameter |
Finding |
Points |
gender |
male |
20.7 |
|
female |
0 |
diabetes mellitus |
no |
0 |
|
yes |
25.9 |
continuous renal replacement |
no |
0 |
|
yes |
19.8 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 221.6
• The higher the score the greater the risk of readmission to the MICU.
Score |
Risk of Readmission |
< 35.9 |
< 1% |
35.9 to 73.8 |
(0.10554 * (points)) - 2.7889 |
73.8 to 140.7 |
(0.00592 * ((points)^2)) - (0.5856 * (points)) + 14.78 |
> 140.7 |
> 50% |
Purpose: To evaluate a patient being discharged from the medical intensive care unit (MICU) for risk of readmission using the model of Jo et al.
Specialty: Critical Care, Emergency Medicine
Objective: risk factors, severity, prognosis, stage
ICD-10: ,