Mady Ahmed Fouad, Al-Odat Mohammed Ali, Alshaya Rayan, Hussien Sahar, Aletreby Ahmed, Hamido Hend Mohammed, Aletreby Waleed Tharwat
Department of Critical Care, King Saud Medical City, Riyadh, Saudi Arabia.
Department of Anesthesia, Faculty of Medicine, Tanta University, Tanta, Egypt.
Saudi J Med Med Sci. 2023 Apr-Jun;11(2):143-149. doi: 10.4103/sjmms.sjmms_634_22. Epub 2023 Apr 12.
ICU readmission is associated with poor outcomes. Few studies have directly compared the outcomes of early versus late readmissions, especially in Saudi Arabia.
To compare the outcomes between early and late ICU readmissions, mainly with regards to hospital mortality.
This retrospective study included unique patients who, within the same hospitalization, were admitted to the ICU, discharged to the general wards, and then readmitted to the ICU of King Saud Medical City, Riyadh, Saudi Arabia, between January 01, 2015, and June 30, 2022. Patients readmitted within 2 calendar days were grouped into the Early readmission group, while those readmitted after 2 calendar days were in the Late readmission group.
A total of 997 patients were included, of which 753 (75.5%) belonged to the Late group. The mortality rate in the Late group was significantly higher than that in the Early group (37.6% vs. 29.5%, respectively; 95% CI: 1%-14.8%; = 0.03). The readmission length of stay (LOS) and severity score of both groups were similar. The odds ratio of mortality for the Early group was 0.71 (95% CI: 0.51-0.98, = 0.04); other significant risk factors were age (OR = 1.023, 95% CI: 1.016-1.03; < 0.001) and readmission LOS (OR = 1.017, 95% CI: 1.009-1.026; < 0.001). The most common reason for readmission in the Early group was high Modified Early Warning Score, while in the Late group, it was respiratory failure followed by sepsis or septic shock.
Compared with late readmission, early readmission was associated with lower mortality, but not with lower LOS or severity score.
重症监护病房（ICU）再入院与不良预后相关。很少有研究直接比较早期再入院和晚期再入院的结局，尤其是在沙特阿拉伯。
比较早期和晚期ICU再入院的结局，主要关注医院死亡率。
这项回顾性研究纳入了在沙特阿拉伯利雅得国王沙特医疗城于2015年1月1日至2022年6月30日期间，在同一住院期间入住ICU、出院至普通病房后又再次入住ICU的独特患者。在2个日历日内再次入院的患者被归入早期再入院组，而在2个日历日后再次入院的患者则归入晚期再入院组。
总共纳入了997例患者，其中753例（75.5%）属于晚期组。晚期组的死亡率显著高于早期组（分别为37.6%和29.5%；95%置信区间：1%-14.8%；P = 0.03）。两组的再入院住院时间（LOS）和严重程度评分相似。早期组的死亡比值比为0.71（95%置信区间：0.51-0.98，P = 0.04）；其他显著的风险因素是年龄（比值比 = 1.023，95%置信区间：1.016-1.03；P < 0.001）和再入院LOS（比值比 = 1.017，95%置信区间：1.009-1.026；P < 0.001）。早期组再入院的最常见原因是改良早期预警评分高，而晚期组则是呼吸衰竭，其次是脓毒症或脓毒性休克。
与晚期再入院相比，早期再入院与较低的死亡率相关，但与较低的LOS或严重程度评分无关。
