Association of severity of illness and intensive care unit readmission: A systematic review

Evan G Wong; Ann M Parker; Doris G Leung; Emily P Brigham; Alicia I Arbaje

doi:10.1016/j.hrtlng.2015.10.040

Association of severity of illness and intensive care unit readmission: A systematic review

Heart Lung. 2016 Jan-Feb;45(1):3-9.e2. doi: 10.1016/j.hrtlng.2015.10.040.

Authors

Evan G Wong¹, Ann M Parker², Doris G Leung³, Emily P Brigham², Alicia I Arbaje⁴

Affiliations

¹ Department of Surgery, McGill University, Montreal, Quebec, Canada; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: evan.wong@mail.mcgill.ca.
² Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
³ The Hugo W. Moser Research Institute, Kennedy Krieger Institute, Baltimore, MD, USA; Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
⁴ Division of Geriatric Medicine and Gerontology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.

Abstract

Objectives: To determine whether ICU readmission is associated with higher severity of illness scores in adult patients.

Background: Readmissions to the intensive care unit (ICU) are associated with increased costs, morbidity, and mortality.

Methods: We performed searches of MEDLINE, EMBASE, and grey literature databases. We selected studies reporting data from adults who were hospitalized in an ICU, received severity of illness scores, and were discharged from the ICU. Characteristics of readmitted and non-readmitted patients were examined.

Results: We screened 4766 publications and included 31 studies in our analysis. In most studies, severity of illness scores were higher in patients readmitted to the ICU. Readmission was also associated with higher mortality and longer ICU and hospital stays. Excessive heterogeneity precluded the reporting of results in the form of a meta-analysis.

Conclusions: ICU readmission is associated with higher severity of illness scores during the same hospitalization in adult patients.

Keywords: Intensive care unit; Outcomes; Readmission; Severity of illness; Systematic review.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Review
Systematic Review

MeSH terms

Adult
Humans
Intensive Care Units / statistics & numerical data*
Length of Stay
Patient Discharge
Patient Readmission / statistics & numerical data*

Abstract

Publication types

MeSH terms

Grants and funding