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Comparison of Unplanned Intensive Care Unit Readmission Scores: A Prospective Cohort Study
PURPOSE: Early discharge from the intensive care unit (ICU) may constitute a strategy of resource consumption optimization; however, unplanned readmission of hospitalized patients to an ICU is associated with a worse outcome. We aimed to compare the effectiveness of the Stability and Workload Index...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4658118/ https://www.ncbi.nlm.nih.gov/pubmed/26600463 http://dx.doi.org/10.1371/journal.pone.0143127 |
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author | Rosa, Regis Goulart Roehrig, Cintia de Oliveira, Roselaine Pinheiro Maccari, Juçara Gasparetto Antônio, Ana Carolina Peçanha Castro, Priscylla de Souza Neto, Felippe Leopoldo Dexheimer Balzano, Patrícia de Campos Teixeira, Cassiano |
author_facet | Rosa, Regis Goulart Roehrig, Cintia de Oliveira, Roselaine Pinheiro Maccari, Juçara Gasparetto Antônio, Ana Carolina Peçanha Castro, Priscylla de Souza Neto, Felippe Leopoldo Dexheimer Balzano, Patrícia de Campos Teixeira, Cassiano |
author_sort | Rosa, Regis Goulart |
collection | PubMed |
description | PURPOSE: Early discharge from the intensive care unit (ICU) may constitute a strategy of resource consumption optimization; however, unplanned readmission of hospitalized patients to an ICU is associated with a worse outcome. We aimed to compare the effectiveness of the Stability and Workload Index for Transfer score (SWIFT), Sequential Organ Failure Assessment score (SOFA) and simplified Therapeutic Intervention Scoring System (TISS-28) in predicting unplanned ICU readmission or unexpected death in the first 48 hours after discharge from the ICU. METHODS: We conducted a prospective cohort study in a single tertiary hospital in southern Brazil. All adult patients admitted to the ICU for more than 24 hours from January 2008 to December 2009 were evaluated. SWIFT, SOFA and TISS-28 scores were calculated on the day of discharge from the ICU. A stepwise logistic regression was conducted to evaluate the effectiveness of these scores in predicting unplanned ICU readmission or unexpected death in the first 48 hours after discharge from the ICU. Moreover, we conducted a direct accuracy comparison among SWIFT, SOFA and TISS-28 scores. RESULTS: A total of 1,277 patients were discharged from the ICU during the study period. The rate of unplanned ICU readmission or unexpected death in the first 48 hours after discharge from the ICU was 15% (192 patients). In the multivariate analysis, age (P = 0.001), length of ICU stay (P = 0.01), cirrhosis (P = 0.03), SWIFT (P = 0.001), SOFA (P = 0.01) and TISS-28 (P<0.001) constituted predictors of unplanned ICU readmission or unexpected death. The SWIFT, SOFA and TISS-28 scores showed similar predictive accuracy (AUC values were 0.66, 0.65 and 0.74, respectively; P = 0.58). CONCLUSIONS: SWIFT, SOFA and TISS-28 on the day of discharge from the ICU have only moderate accuracy in predicting ICU readmission or death. The present study did not find any differences in accuracy among the three scores. |
format | Online Article Text |
id | pubmed-4658118 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-46581182015-12-02 Comparison of Unplanned Intensive Care Unit Readmission Scores: A Prospective Cohort Study Rosa, Regis Goulart Roehrig, Cintia de Oliveira, Roselaine Pinheiro Maccari, Juçara Gasparetto Antônio, Ana Carolina Peçanha Castro, Priscylla de Souza Neto, Felippe Leopoldo Dexheimer Balzano, Patrícia de Campos Teixeira, Cassiano PLoS One Research Article PURPOSE: Early discharge from the intensive care unit (ICU) may constitute a strategy of resource consumption optimization; however, unplanned readmission of hospitalized patients to an ICU is associated with a worse outcome. We aimed to compare the effectiveness of the Stability and Workload Index for Transfer score (SWIFT), Sequential Organ Failure Assessment score (SOFA) and simplified Therapeutic Intervention Scoring System (TISS-28) in predicting unplanned ICU readmission or unexpected death in the first 48 hours after discharge from the ICU. METHODS: We conducted a prospective cohort study in a single tertiary hospital in southern Brazil. All adult patients admitted to the ICU for more than 24 hours from January 2008 to December 2009 were evaluated. SWIFT, SOFA and TISS-28 scores were calculated on the day of discharge from the ICU. A stepwise logistic regression was conducted to evaluate the effectiveness of these scores in predicting unplanned ICU readmission or unexpected death in the first 48 hours after discharge from the ICU. Moreover, we conducted a direct accuracy comparison among SWIFT, SOFA and TISS-28 scores. RESULTS: A total of 1,277 patients were discharged from the ICU during the study period. The rate of unplanned ICU readmission or unexpected death in the first 48 hours after discharge from the ICU was 15% (192 patients). In the multivariate analysis, age (P = 0.001), length of ICU stay (P = 0.01), cirrhosis (P = 0.03), SWIFT (P = 0.001), SOFA (P = 0.01) and TISS-28 (P<0.001) constituted predictors of unplanned ICU readmission or unexpected death. The SWIFT, SOFA and TISS-28 scores showed similar predictive accuracy (AUC values were 0.66, 0.65 and 0.74, respectively; P = 0.58). CONCLUSIONS: SWIFT, SOFA and TISS-28 on the day of discharge from the ICU have only moderate accuracy in predicting ICU readmission or death. The present study did not find any differences in accuracy among the three scores. Public Library of Science 2015-11-23 /pmc/articles/PMC4658118/ /pubmed/26600463 http://dx.doi.org/10.1371/journal.pone.0143127 Text en © 2015 Rosa et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Rosa, Regis Goulart Roehrig, Cintia de Oliveira, Roselaine Pinheiro Maccari, Juçara Gasparetto Antônio, Ana Carolina Peçanha Castro, Priscylla de Souza Neto, Felippe Leopoldo Dexheimer Balzano, Patrícia de Campos Teixeira, Cassiano Comparison of Unplanned Intensive Care Unit Readmission Scores: A Prospective Cohort Study |
title | Comparison of Unplanned Intensive Care Unit Readmission Scores: A Prospective Cohort Study |
title_full | Comparison of Unplanned Intensive Care Unit Readmission Scores: A Prospective Cohort Study |
title_fullStr | Comparison of Unplanned Intensive Care Unit Readmission Scores: A Prospective Cohort Study |
title_full_unstemmed | Comparison of Unplanned Intensive Care Unit Readmission Scores: A Prospective Cohort Study |
title_short | Comparison of Unplanned Intensive Care Unit Readmission Scores: A Prospective Cohort Study |
title_sort | comparison of unplanned intensive care unit readmission scores: a prospective cohort study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4658118/ https://www.ncbi.nlm.nih.gov/pubmed/26600463 http://dx.doi.org/10.1371/journal.pone.0143127 |
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