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Readmissions to General ICUs in a Geographic Area of Poland Are Seemingly Associated with Better Outcomes

Background: Various factors can contribute to high mortality rates in intensive care units (ICUs). Here, we intended to define a population of patients readmitted to general ICUs in Poland and to identify independent predictors of ICU readmission. Methods: Data derived from adult ICU admissions from...

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Autores principales: Grochla, Marek, Saucha, Wojciech, Ciesla, Daniel, Knapik, Piotr
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7014014/
https://www.ncbi.nlm.nih.gov/pubmed/31963101
http://dx.doi.org/10.3390/ijerph17020565
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author Grochla, Marek
Saucha, Wojciech
Ciesla, Daniel
Knapik, Piotr
author_facet Grochla, Marek
Saucha, Wojciech
Ciesla, Daniel
Knapik, Piotr
author_sort Grochla, Marek
collection PubMed
description Background: Various factors can contribute to high mortality rates in intensive care units (ICUs). Here, we intended to define a population of patients readmitted to general ICUs in Poland and to identify independent predictors of ICU readmission. Methods: Data derived from adult ICU admissions from the Silesian region of Poland were analyzed. First-time ICU readmissions (≤30 days from ICU discharge after index admissions) were compared with first-time ICU admissions. Pre-admission and admission variables that independently influenced the need for ICU readmission were identified. Results: Among the 21,495 ICU admissions, 839 were first-time readmissions (3.9%). Patients readmitted to the ICU had lower mean APACHE II (21.2 ± 8.0 vs. 23.2 ± 8.8, p < 0.001) and TISS-28 scores (33.7 ± 7.4 vs. 35.2 ± 7.8, p < 0.001) in the initial 24 h following ICU admission, compared to first-time admissions. ICU readmissions were associated with lower mortality vs. first-time admissions (39.2% vs. 44.3%, p = 0.004). Independent predictors for ICU readmission included the admission from a surgical ward (among admission sources), chronic respiratory failure, cachexia, previous stroke, chronic neurological diseases (among co-morbidities), and multiple trauma or infection (among primary reasons for ICU admission). Conclusions: High mortality associated with first-time ICU admissions is associated with a lower mortality rate during ICU readmissions.
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spelling pubmed-70140142020-03-09 Readmissions to General ICUs in a Geographic Area of Poland Are Seemingly Associated with Better Outcomes Grochla, Marek Saucha, Wojciech Ciesla, Daniel Knapik, Piotr Int J Environ Res Public Health Article Background: Various factors can contribute to high mortality rates in intensive care units (ICUs). Here, we intended to define a population of patients readmitted to general ICUs in Poland and to identify independent predictors of ICU readmission. Methods: Data derived from adult ICU admissions from the Silesian region of Poland were analyzed. First-time ICU readmissions (≤30 days from ICU discharge after index admissions) were compared with first-time ICU admissions. Pre-admission and admission variables that independently influenced the need for ICU readmission were identified. Results: Among the 21,495 ICU admissions, 839 were first-time readmissions (3.9%). Patients readmitted to the ICU had lower mean APACHE II (21.2 ± 8.0 vs. 23.2 ± 8.8, p < 0.001) and TISS-28 scores (33.7 ± 7.4 vs. 35.2 ± 7.8, p < 0.001) in the initial 24 h following ICU admission, compared to first-time admissions. ICU readmissions were associated with lower mortality vs. first-time admissions (39.2% vs. 44.3%, p = 0.004). Independent predictors for ICU readmission included the admission from a surgical ward (among admission sources), chronic respiratory failure, cachexia, previous stroke, chronic neurological diseases (among co-morbidities), and multiple trauma or infection (among primary reasons for ICU admission). Conclusions: High mortality associated with first-time ICU admissions is associated with a lower mortality rate during ICU readmissions. MDPI 2020-01-16 2020-01 /pmc/articles/PMC7014014/ /pubmed/31963101 http://dx.doi.org/10.3390/ijerph17020565 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Grochla, Marek
Saucha, Wojciech
Ciesla, Daniel
Knapik, Piotr
Readmissions to General ICUs in a Geographic Area of Poland Are Seemingly Associated with Better Outcomes
title Readmissions to General ICUs in a Geographic Area of Poland Are Seemingly Associated with Better Outcomes
title_full Readmissions to General ICUs in a Geographic Area of Poland Are Seemingly Associated with Better Outcomes
title_fullStr Readmissions to General ICUs in a Geographic Area of Poland Are Seemingly Associated with Better Outcomes
title_full_unstemmed Readmissions to General ICUs in a Geographic Area of Poland Are Seemingly Associated with Better Outcomes
title_short Readmissions to General ICUs in a Geographic Area of Poland Are Seemingly Associated with Better Outcomes
title_sort readmissions to general icus in a geographic area of poland are seemingly associated with better outcomes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7014014/
https://www.ncbi.nlm.nih.gov/pubmed/31963101
http://dx.doi.org/10.3390/ijerph17020565
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