The functional outcome of patients requiring intensive care readmission

Introduction

Rates of readmission to the ICU are often cited as controversial indices of quality of intensive care, adequacy of follow-up and as guides to resource allocation. Nonetheless there are few data on the long-term functional outcome of ICU recidivists: we set out to study this.

Methods

With ethical approval, from a prospectively collected database of all ICU admissions from 2004, we identified all readmissions to our ICU from within the hospital. We identified survivors from the database, and contacted them, 2–3 years later, to assess their functional outcome, as the Glasgow Outcome Score (GOS) and Karnofsky score.

Results

Of 97 readmissions, 79 (81%) survived the ICU. Most of them (57%) came from the high-dependency unit (HDU), of whom 74% survived. Thirty-three per cent came from other wards and 10% from theatre: 90% of each of these groups survived the ICU. Further data on these groups' interim survival and functional outcomes are presented.

Conclusion

Survival rates among those readmitted are high. Those returning from the HDU represent a cohort at higher risk of mortality. The functional status after 2.5 years varies particularly with the timing of readmission, readmission diagnosis and APACHE score at readmission.