Factors associated with early readmission to Intensive Care Units. A systematic review

Abstract

Introduction

Readmission to the Intensive Care Unit (ICU) determines worse outcomes such as higher mortality, increased hospital and ICU stay, as well as higher economic costs. When deciding which patient is suitable for transfer from the ICU, factors associated with readmission must be considered to avoid it. Knowledge of these factors helps professionals identify those patients with a higher probability of readmission, prioritizing their care, establishing and preparing interventions that seek to reduce the risk of readmission.

Objective

Determine factors associated with early readmission in patients transferred from the ICU to general hospitalization wards of the same hospital.

Method

Studies were retrieved from databases: CINAHL, EMBASE, BVS, PubMed, SCOPUS and WOS identifying original studies on adult patients readmitted early to the ICU during the same hospitalization, in any language and without time limit. Studies of patient readmission after seven days, review articles, editorials, protocols, clinical guidelines, qualitative studies and opinion surveys were excluded.

Results

Of 755 files found, 28 articles made up the review. The most analyzed factors were age, sex, severity of the disease, comorbidity, length of stay in the ICU, mechanical ventilation and nocturnal discharge. Those most frequently associated with readmission were age, severity of illness, comorbidity, and length of ICU stay. NEWS, MEWS, and SWIFT scores were also factors associated with readmission.

Conclusion

More research is needed to identify those modifiable factors that can decrease readmission rates. Using readmission prediction instruments at the time of discharge could support the decision of which patient is most prepared for it.