Mortality Rates in Early versus Late Intensive Care Unit Readmission

Ahmed Fouad Mady; Mohammed Ali Al-Odat; Rayan Alshaya; Sahar Hussien; Ahmed Aletreby; Hend Mohammed Hamido; Waleed Tharwat Aletreby

doi:10.4103/sjmms.sjmms_634_22

Mortality Rates in Early versus Late Intensive Care Unit Readmission

Saudi J Med Med Sci. 2023 Apr-Jun;11(2):143-149. doi: 10.4103/sjmms.sjmms_634_22. Epub 2023 Apr 12.

Authors

Ahmed Fouad Mady^{1

2}, Mohammed Ali Al-Odat¹, Rayan Alshaya¹, Sahar Hussien³, Ahmed Aletreby⁴, Hend Mohammed Hamido⁵, Waleed Tharwat Aletreby¹

Affiliations

¹ Department of Critical Care, King Saud Medical City, Riyadh, Saudi Arabia.
² Department of Anesthesia, Faculty of Medicine, Tanta University, Tanta, Egypt.
³ Department of Internal Medicine, King Saud Medical City, Riyadh, Saudi Arabia.
⁴ Faculty of Medicine, Alexandria University, Alexandria, Egypt.
⁵ Department of Obstetrics and Gynecology, King Saud Medical City, Riyadh, Saudi Arabia.

Abstract

Background: ICU readmission is associated with poor outcomes. Few studies have directly compared the outcomes of early versus late readmissions, especially in Saudi Arabia.

Objective: To compare the outcomes between early and late ICU readmissions, mainly with regards to hospital mortality.

Methods: 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.

Results: 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%; P = 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, P = 0.04); other significant risk factors were age (OR = 1.023, 95% CI: 1.016-1.03; P < 0.001) and readmission LOS (OR = 1.017, 95% CI: 1.009-1.026; P < 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.

Conclusion: Compared with late readmission, early readmission was associated with lower mortality, but not with lower LOS or severity score.

Keywords: Early; Saudi Arabia; intensive care unit; late; mortality; patient readmission.