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Readmission of Surgical Patient to Intensive Care Unit Risk Factors

Purpose: To identify a surgical patient who is being discharged from the surgical ICU who may be readmitted based on the risk factors of Kaben et al.

Description

Kaben et al identified risk factors associated with readmission of a surgical patient to the intensive care unit (ICU) following discharge. This can help to identify a patient who may need more aggressive management and closer monitoring. The authors are Friedrich Schiller University in Jena, Germany.


 

Patient selection: surgical patients admitted postoperatively

 

Most readmissions occurred within the first 5 weeks after discharge (see Figure 1).

 

Risk factors for readmission:

(1) older age

(2) higher maximum SOFA score during the ICU stay

(3) higher C-reactive protein (CRP) on the day of ICU discharge

 

Risk Factor

Odds Ratio

age in years

1.13 for each 10 years

SOFA score

1.04 for each point

CRP in mg/L

1.02 for each 10 unit increase

 

where:

• The maximum SOFA score is 24.

• The final odds ratio for age could be either 1.13^((age)/10) or 1.13^(INT((age)/10)).

• The final overall odds ratio is the product of the 3 parameters.

 

A patient who is readmitted has a significant risk for in-hospital mortality.

 


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Specialty

Objective

ICD-10