Kang Young Ae
Young Ae Kang is Clinical Nurse Specialist, Cardiovascular Surgery ICU, Asan Medical Center, 88, Olympic-ro, 43-gil, Songpa-gu, Seoul, 138-736, Korea (
AACN Adv Crit Care. 2016 Feb;27(1):29-39. doi: 10.4037/aacnacc2016451.
Unplanned readmission to the intensive care unit (ICU) is associated with poor prognosis, longer hospital stay, increased costs, and higher mortality rate. In this retrospective study, involving 1368 patients, the risk factors for and outcomes of ICU readmission after cardiac surgery were analyzed. The readmission rate was 5.9%, and the most common reason for readmission was cardiac issues. Preoperative risk factors were comorbid conditions, mechanical ventilation, and admission route. Perioperative risk factors were nonelective surgery, duration of cardiopulmonary bypass, and longer operation time. Postoperative risk factors were prolonged mechanical ventilation time, new-onset arrhythmia, unplanned reoperation, massive blood transfusion, prolonged inotropic infusions, and complications. Other factors were high blood glucose level, hemoglobin level, and score on the Acute Physiology and Chronic Health Evaluation II. In-hospital stay was longer and late mortality was higher in the readmitted group. These data could help clinical practitioners create improved ICU discharge protocols or treatment algorithms to reduce length of stay or to reduce readmissions.
重症监护病房(ICU)的非计划再入院与预后不良、住院时间延长、费用增加和死亡率升高相关。在这项涉及1368例患者的回顾性研究中,分析了心脏手术后ICU再入院的危险因素和结局。再入院率为5.9%,再入院的最常见原因是心脏问题。术前危险因素为合并症、机械通气和入院途径。围手术期危险因素为非择期手术、体外循环时间和手术时间延长。术后危险因素为机械通气时间延长、新发心律失常、非计划再次手术、大量输血、血管活性药物输注时间延长和并发症。其他因素为血糖水平、血红蛋白水平以及急性生理学与慢性健康状况评分系统II评分。再入院组的住院时间更长,晚期死亡率更高。这些数据有助于临床医生制定更好的ICU出院方案或治疗算法,以缩短住院时间或减少再入院率。