Wildeman, L. (Lies) (2016) Characteristics and risk factors of readmission to the ICU in Isala : A case-control study. thesis, Medicine.
Full text available on request.Abstract
Background: Readmission to the intensive care unit (ICU) is associated with higher morbidity, mortality, and costs. The cause of readmission is multifactorial. Many risk factors for readmission are already identified. However, it is difficult to extrapolate these results to every ICU due to differences in organizational level, case-mix, facilities, and organization of a rapid response system (RRS). Aim: To identify characteristics and risk factors for readmission to the ICU within the context of Isala. Thereby to investigate how the RRS functions in the light of early recognition of patients prone to readmission and non-elective admission to the ICU. Methods: An explorative, retrospective, case-control study of 99 cases readmitted to the ICU and 99 controls matched for admission diagnosis and severity of illness was conducted over 2015. Conditional logistic regression was used to identify risk factors for ICU readmission. Results: 127 patients were readmitted to the ICU in 2015 (readmission rate = 4.1%). The cases (n=99) had a mortality rate of 16.2%. The final logistic regression model included a last measured early warning score (EWS) ≥4 before ICU readmission (odds ratio [OR]=6.29; 95% confidence interval [95% CI]=1.68-23.52; p<0.01), having renal disease as comorbidity (OR=3.37 [0.95-12.03]; p=0.06) en not following the EWS protocol prior to readmission (OR=2.11 [0.80-5.57]; p=0.13). The EWS protocol was correctly followed before (re)admission to the ICU in 60.2% of the cases and in 55.8% of the unplanned admissions from the ward. Conclusion A higher last measured EWS score before ICU readmission is an independent risk factor for readmission. The EWS protocol was poorly followed, especially when the EWS was moderately increased.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair begeleider: and Haringman, dr. J.J. and Locatie: Isala, Zwolle and Afdeling: intensive care |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:52 |
| Last Modified: | 25 Jun 2020 10:52 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1276 |
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