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Readmission and hospital mortality after ICU discharge of critically ill cancer patients

BACKGROUND: Intensive care unit (ICU) readmission is generally associated with increased hospital stays and increased mortality. However, there are limited data on ICU readmission in critically ill cancer patients. METHOD: We conducted a retrospective cohort study based on the prospective registry o...

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Autores principales: Jeong, Byeong-Ho, Na, Soo Jin, Lee, Dae-Sang, Chung, Chi Ryang, Suh, Gee Young, Jeon, Kyeongman
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6345475/
https://www.ncbi.nlm.nih.gov/pubmed/30677085
http://dx.doi.org/10.1371/journal.pone.0211240
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author Jeong, Byeong-Ho
Na, Soo Jin
Lee, Dae-Sang
Chung, Chi Ryang
Suh, Gee Young
Jeon, Kyeongman
author_facet Jeong, Byeong-Ho
Na, Soo Jin
Lee, Dae-Sang
Chung, Chi Ryang
Suh, Gee Young
Jeon, Kyeongman
author_sort Jeong, Byeong-Ho
collection PubMed
description BACKGROUND: Intensive care unit (ICU) readmission is generally associated with increased hospital stays and increased mortality. However, there are limited data on ICU readmission in critically ill cancer patients. METHOD: We conducted a retrospective cohort study based on the prospective registry of all critically ill cancer patients admitted to the oncology medical ICU between January 2012 and December 2013. After excluding patients who were discharged to another hospital or decided to end-of-life care, we divided the enrolled patients into four groups according to the time period from ICU discharge to unexpected events (ICU readmission or ward death) as follows: no (without ICU readmission or death, n = 456), early (within 2 days, n = 42), intermediate (between 2 and 7 days, n = 64), and late event groups (after 7 days of index ICU discharge, n = 129). The independent risk factors associated with ICU readmission or unexpected death after ICU discharge were also analyzed using multinomial logistic regression model. RESULTS: There were no differences in the reasons for ICU readmission across the groups. ICU mortality did not differ among the groups, but hospital mortality was significantly higher in the late event group than in the early event group. Mechanical ventilation during ICU stay, tachycardia, decreased mental status, and thrombocytopenia on the day of index ICU discharge increased the risk of early ICU readmission or unexpected ward death, while admission through the emergency room and sepsis and respiratory failure as the reasons for index ICU admission were associated with increased risk of late readmission or unexpected ward death. Interestingly, recent chemotherapy within 4 weeks before index ICU admission was inversely associated with the risk of late readmission or unexpected ward death. CONCLUSION: In critically ill cancer patients, patient characteristics predicting ICU readmission or unexpected ward death were different according to the time period between index ICU discharge and the events.
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spelling pubmed-63454752019-02-02 Readmission and hospital mortality after ICU discharge of critically ill cancer patients Jeong, Byeong-Ho Na, Soo Jin Lee, Dae-Sang Chung, Chi Ryang Suh, Gee Young Jeon, Kyeongman PLoS One Research Article BACKGROUND: Intensive care unit (ICU) readmission is generally associated with increased hospital stays and increased mortality. However, there are limited data on ICU readmission in critically ill cancer patients. METHOD: We conducted a retrospective cohort study based on the prospective registry of all critically ill cancer patients admitted to the oncology medical ICU between January 2012 and December 2013. After excluding patients who were discharged to another hospital or decided to end-of-life care, we divided the enrolled patients into four groups according to the time period from ICU discharge to unexpected events (ICU readmission or ward death) as follows: no (without ICU readmission or death, n = 456), early (within 2 days, n = 42), intermediate (between 2 and 7 days, n = 64), and late event groups (after 7 days of index ICU discharge, n = 129). The independent risk factors associated with ICU readmission or unexpected death after ICU discharge were also analyzed using multinomial logistic regression model. RESULTS: There were no differences in the reasons for ICU readmission across the groups. ICU mortality did not differ among the groups, but hospital mortality was significantly higher in the late event group than in the early event group. Mechanical ventilation during ICU stay, tachycardia, decreased mental status, and thrombocytopenia on the day of index ICU discharge increased the risk of early ICU readmission or unexpected ward death, while admission through the emergency room and sepsis and respiratory failure as the reasons for index ICU admission were associated with increased risk of late readmission or unexpected ward death. Interestingly, recent chemotherapy within 4 weeks before index ICU admission was inversely associated with the risk of late readmission or unexpected ward death. CONCLUSION: In critically ill cancer patients, patient characteristics predicting ICU readmission or unexpected ward death were different according to the time period between index ICU discharge and the events. Public Library of Science 2019-01-24 /pmc/articles/PMC6345475/ /pubmed/30677085 http://dx.doi.org/10.1371/journal.pone.0211240 Text en © 2019 Jeong 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 (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Jeong, Byeong-Ho
Na, Soo Jin
Lee, Dae-Sang
Chung, Chi Ryang
Suh, Gee Young
Jeon, Kyeongman
Readmission and hospital mortality after ICU discharge of critically ill cancer patients
title Readmission and hospital mortality after ICU discharge of critically ill cancer patients
title_full Readmission and hospital mortality after ICU discharge of critically ill cancer patients
title_fullStr Readmission and hospital mortality after ICU discharge of critically ill cancer patients
title_full_unstemmed Readmission and hospital mortality after ICU discharge of critically ill cancer patients
title_short Readmission and hospital mortality after ICU discharge of critically ill cancer patients
title_sort readmission and hospital mortality after icu discharge of critically ill cancer patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6345475/
https://www.ncbi.nlm.nih.gov/pubmed/30677085
http://dx.doi.org/10.1371/journal.pone.0211240
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