Tracheostomy as an Independent Risk Factor of ICU Readmission
Journal Title: International Journal of Health Sciences and Research - Year 2017, Vol 7, Issue 6
Abstract
Readmission to Intensive Care Unit (ICU) is associated with poor patients’ outcomes. Prediction of risk of ICU readmission may help improve discharge decision making. Tracheostomies are increasing in ICU because of the safety of the procedure, and its benefits in patients’ management. However, studies are scarce on the evaluation of tracheostomy as an independent risk factor of ICU readmission. Objective: To investigate whether discharge from ICU with tracheostomy is an independent risk factor of ICU readmission. Design: Retrospective single-center observational study, on patients discharged from ICU of King Saud Medical City (KSA – Riyadh) to identify differences between readmitted and non-readmitted patients, and recognize independent risks of readmission through logistic regression. Results: Readmitted patients had higher average age and average APACHE 4 score, longer average length of stay, lower GCS on discharge, more tracheostomized patients, and were more frequently medical cases. A well fitted multivariate logistic regression model identified Age (OR 1.011, 95% CI: 1.001 – 1.021), LOS (OR 1.013, 95% CI: 1.004 – 1.021), APACHE 4 score (OR 1.01, 95% CI: 1.003 – 1.017), GCS (OR 0.86, 95% CI: 0.78 – 0.95), and tracheostomy (OR 2.7, 95% CI: 1.4 - 5) as risk factors of ICU readmission. The predictive model of readmission had AUC of 0.82(95% CI: 0.78 – 0.86). A predictive nomogram of the probability of readmission was constructed to be used for individual patients using these five factors. Conclusion: There is evidence that discharge from the ICU with tracheostomy is an independent risk of ICU readmission.
Authors and Affiliations
Waleed Th. Aletreby
Keywords
Related Articles
- EP ID EP370016
- DOI -
- Views 80
- Downloads 0
Cytodiagnosis of Idiopathic Calcinosis Cutis -A Rare Diagnosis in Three Cases with Review of Literature
Calcinosis cutis is a rare soft tissue lesion characterized by the deposition of calcium salts. There are varied clinical settings attributed to calcium deposition and these can be subjected to fine-needle aspiration (FN...
A Diagnosis Model for Job Motivation of Public Health Workers in Rural Odisha, India
The problem of lack of professional health service providers in rural areas of India has been an area of discussion since the 1960s. Despite the implementation of National Rural Health Mission over a decade since 2005, t...
Simplest Way to Fabricate Custom Made Ocular Prosthesis- A Case Report
Loss of eye whether congenital or due to trauma causes disfigurement and affects the patient psychologically. An ocular prosthesis can improve the esthetic as well as confidence of the patients. Ocular prosthesis can be...
Comparison of the Nanocrystalline Silver (NCS) Dressing Over Paraffin Gauze Dressing on Split-Thickness Skin Graft Donor Site
Background: Different dressing methods are used in split thickness skin grafting donor sites; none has a superior effect than other. The time tested paraffin gauze dressing is still preferred by many surgeons because it...
Lymphatic Filariasis (LF): Treatment Receiving Types in Bangladesh
Background: Lymphatic filariasis impairs the lymphatic system and can lead to the abnormal enlargement of body parts, causing pain, severe disability and social stigma. 856 million people in 52 countries worldwide remain...