The effect of comorbidities on risk of intensive care readmission during the same hospitalization: a linked data cohort study

Ho, Kwok M., Dobb, Geoffrey J., Lee, Kok Y., Finn, Judith, Knuiman, Matthew and Webb, Steven A.R. (2009) The effect of comorbidities on risk of intensive care readmission during the same hospitalization: a linked data cohort study. Journal of Critical Care, 24 1: 101-107. doi:10.1016/j.jcrc.2007.11.015


Author Ho, Kwok M.
Dobb, Geoffrey J.
Lee, Kok Y.
Finn, Judith
Knuiman, Matthew
Webb, Steven A.R.
Title The effect of comorbidities on risk of intensive care readmission during the same hospitalization: a linked data cohort study
Journal name Journal of Critical Care   Check publisher's open access policy
ISSN 0883-9441
1557-8615
Publication date 2009-03
Sub-type Article (original research)
DOI 10.1016/j.jcrc.2007.11.015
Open Access Status
Volume 24
Issue 1
Start page 101
End page 107
Total pages 7
Place of publication Maryland Heights, MO, United States
Publisher W.B. Saunders
Language eng
Formatted abstract
Purpose: The aim of this study is to assess the effect of comorbidities on risk of readmission to an intensive care unit (ICU) and the excess hospital mortality associated with ICU readmissions.

Materials and Methods: A cohort study used clinical data from a 22-bed multidisciplinary ICU in a university hospital and comorbidity data from the Western Australian hospital morbidity database.

Results: From 16 926 consecutive ICU admissions between 1987 and 2002, and 654 (3.9%) of these patients were readmitted to ICU readmissions within the same hospitalization. Patients with readmission were older, more likely to be originally admitted from the operating theatre or hospital ward, had a higher Acute Physiology and Chronic Health Evaluation (APACHE)-predicted mortality, and had more comorbidities when compared with patients without readmission. The number of Charlson comorbidities was significantly associated with late readmission (>72 hours) but not early readmission (≤72 hours) in the multivariate analysis. Both early and late ICU readmissions were associated with an increased risk of hospital mortality (odds ratio, 1.68; 95% confidence interval, 1.18-2.39; P = .004; odds ratio, 1.45; 95% confidence interval, 1.05-1.99; P = .022, respectively) after adjusting for age, admission source, type of admission, the APACHE-predicted mortality, and the number of Charlson comorbidities and APACHE chronic health conditions.

Conclusions: Comorbidity was a risk factor for late ICU readmission. Comorbidities could not account for the excess mortality associated with ICU readmissions. 
Keyword Confounding
ICU clinical indicator
Preexisting disease
Quality of care
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Nursing, Midwifery and Social Work Publications
 
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Created: Fri, 18 Jul 2014, 14:08:42 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work