Rosenberg et al identified factors associated with readmission of a patient to the intensive care unit (ICU) following discharge. These can help identify patients who may benefit from more aggressive management and followup. The authors are from the University of Michigan Health System and Ann Arbor Veterans Administration Health System.


Factors associated with an increased risk of being readmitted to the ICU after release:

(1) significant illness present at the time of initial ICU discharge

(1a) acute physiology score (APS) from APACHE II > 40

(2) site prior to initial ICU admission:

(2a) general medical ward

(2b) transfer from another hospital


The risk factors indicate a failure to completely respond to therapy, whether in the ICU, on the general medical ward or at an outside hospital. This often reflects a sicker patient rather than any deficiency in the quality of care.


An ICU at a tertiary medical center is likely to have a high rate of readmission since the patients are sicker and many are transferred in from outside hospitals.



• The hazard ratios for each risk factors ranged from 1.7 to 2.1.

• The area under the ROC curve was 0.67 (which is mediocre).


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