Allison Patten
University of Chicago Medical Center
Chicago, Illinois
Disclosure information not submitted.
Nicole L Bohr, PhD, RN
Manager
University of Chicago Department of Nursing Research and Evidence-Based Practice, United States
Disclosure information not submitted.
Jason Kane, MD, MS, FCCM
Associate Professor of Pediatrics
University of Chicago Medical Center Comer Children's Hospital
Glenview, Illinois
Disclosure information not submitted.
Title: Preliminary Analysis of Factors Associated With PICU Readmission After Hospital Discharge
Introduction: Readmission to an ICU after hospital discharge is associated with poor clinical outcomes during the subsequent ICU stay. Published PICU readmission rates within a year of discharge range from 9.8% to 11%. It is unclear what risk factors increase likelihood of PICU readmission after hospital discharge. The goal of this study was to determine frequency of repeat PICU admission within one year from index PICU admission and compare risk factors of those with PICU readmission to those without.
Methods: In a single urban PICU population, a retrospective review was performed of children under 18 years admitted to the PICU between January 1, 2018 and December 31, 2018. PICU readmission was defined as another PICU admission within 365 days after discharge from index hospitalization. Patient demographics, clinical, and hospital level data were used to identify risk factors that may increase likelihood of PICU readmission. Comparisons were made between those PICU patients with a repeat admission and those without.
Results: To date, 663 patients have been analyzed. Of those, 134 patients (20%) had at least one readmission to the PICU after hospital discharge. For patients readmitted, 81 (60%) had the same diagnosis for their index and at least one PICU readmission. The most common diagnosis for patients readmitted was asthma (17%). Median PICU index admission LOS was longer for those readmitted compared to those not readmitted (3 v 2d, p< 0.0001). Comparing those patients requiring PICU readmission to those who did not, there was a higher percent of non-Hispanic black patients (75.4 v 58.3, p=0.004). Primary respiratory conditions occurred with greater frequency on index admission in those readmitted compared to those who were not (57.5% v 38.9%, p< 0.0001). Also, those readmitted had a higher rate of index discharge to a long-term care facility (16.2% v 3.4%, p < 0.0001).
Conclusion: Preliminary interim analysis of the rate of PICU readmission at our center is higher than previously published rates, with nearly two-thirds of patients readmitted with the same diagnosis as their index admission. PICU LOS, race, and discharge to long-term care appear to be key risk factors for readmission. These data may better inform discharge planning for certain high-risk conditions.