Understanding Patterns and Factors Influencing ICU Readmissions: A Retrospective Analysis in the Context of the COVID-19 Pandemic

Introduction: This retrospective study investigates ICU readmissions within the unique context of the COVID-19 pandemic. Focusing on the ICU setting at a tertiary care hospital during the peak of the pandemic's second wave, the research aims to identify factors influencing readmission rates and their implications. Methods: Utilizing a quantitative approach and a purposive sampling technique, the study analyzes data from ICU readmissions over a six-month period. A structured proforma and checklist were used for data collection, capturing baseline variables, incidence rates, and factors contributing to readmissions. The sample comprised patients readmitted within 48 hours of discharge, above 18 years, excluding those terminally ill or undergoing planned surgeries. Results: Of the 926 shifts out from ICU, 40 patients (4.31%) were readmitted. Predominantly male (72.5%), COVID-19-positive (60%), and aged 18-40 years (57.5%), the readmissions were primarily due to respiratory disorders (82.5%). While initial SOFA scores during shift out were low (60% with scores 0-6), scores above 14 on readmission indicated deterioration. Desaturation (60%) and hypotension (30.5%) were common reasons for readmission. Discussion: Comparison with existing studies reveals similarities in readmission rates but underscores the unique impact of the pandemic. Financial constraints, delayed decisions, and inadequate follow-up care contributed to readmissions. Higher SOFA scores on readmission aligned with studies linking elevated scores to mortality risk. The study emphasizes the role of early warning score documentation and identifies specific causes like postoperative monitoring and inadequate follow-up care. Conclusion: Despite limitations, the study provides insights into ICU readmissions during the pandemic, emphasizing the need for tailored strategies. Stringent discharge criteria, timely monitoring, and comprehensive support systems are crucial. The findings contribute to ongoing discussions on optimizing patient care and call for prospective research to validate these observations.