Status and Risk Factors in Patients Requiring Unplanned Intensive Care Unit Readmission Within 48 Hours: A Retrospective Propensity-Matched Study in China

Yan-Ling Yin,1,* Mei-Rong Sun,1,* Kun Zhang,1 Yu-Hong Chen,1 Jie Zhang,1 Shao-Kun Zhang,1 Li-Li Zhou,1 Yan-Shuo Wu,1 Peng Gao,1 Kang-Kang Shen,1 Zhen-Jie Hu1,2 1Department of ICU, the Fourth Hospital of Hebei Medical University, Shijiazhuang City, Hebei Province, People’s Republic of China; 2Hebei Key Laboratory of Critical Disease Mechanism and Intervention, Shijiazhuang City, Hebei Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhen-Jie Hu, Tel +86-0311-86095588, Email Hu_zhj11@126.comAim: This study investigated the current status and related risk factors of 48-hour unplanned return to the intensive care unit (ICU) to reduce the return rate and improve the quality of critical care management.Methods: Data were collected from 2365 patients discharged from the comprehensive ICU. Multivariate and 1:1 propensity score matching analyses were performed.Results: Forty patients (1.69%) had unplanned readmission to the ICU within 48 hours after transfer. The primary reason for return was respiratory failure (16 patients, 40%). Furthermore, respiratory failure (odds ratio [OR] = 5.994, p = 0.02) and the number of organ failures (OR = 5.679, p = 0.006) were independent risk factors for unplanned ICU readmission. Receiver operating characteristic curves were drawn for the predictive value of the number of organ injuries during a patient’s unplanned transfer to the ICU (area under the curve [AUC] = 0.744, sensitivity = 60%, specificity = 77.5%).Conclusion: The reason for patient transfer and the number of organ injuries during the process were independent risk factors for patients who were critically ill. The number of organs damaged had a predictive value on whether the patient would return to the ICU within 48 hours.Keywords: risk factors, 48-hour unplanned readmission, comprehensive ICU, propensity-matched study, respiratory failure