Clinical Characteristics of Patients Readmitted to the Medical ICU of a University Hospital and the Impact of Readmission on ICU Outcomes

Aim: Intensive Care Unit (ICU) readmissions increase mortality and healthcare costs.Identifying high-risk patients is crucial for improving outcomes and optimizing resources.This study aimed to investigate the incidence, risk factors, and outcomes of unplanned readmissions in a medical ICU. Study Design:This retrospective cohort study included adults admitted to the medical ICU of Gazi University between January 2018 and December 2019.Patients who stayed more than 24 hours were analyzed for ICU readmission during the same hospitalization after transfer to general wards or within 48 hours of discharge to home.Demographic, clinical, and laboratory variables were compared between readmitted and non-readmitted patients.Results: Among 477 ICU admissions, 216 patients who died during the initial stay were excluded.Twenty-seven patients (10.3%) experienced unplanned readmission, while 234 comprised the non-readmission group.The overall ICU mortality during the initial admission was 45.3%.Among patients who survived their initial ICU stay, those who were readmitted had a higher ICU mortality rate (74.1%, p=0.028).Compared with the non-readmission group, readmitted patients more frequently had chronic kidney disease (CKD), malnutrition or impaired oral intake, limited mobilization, and pressure ulcers (p<0.05).They also had a higher requirement for noninvasive mechanical ventilation (NIMV) and high-flow nasal cannula therapy during their initial ICU stay (p<0.05).In multivariate analysis, CKD (odds ratio [OR]: 3.38, 95% confidence interval [CI]: 1.03-11.09),malnutrition or impaired oral intake (OR: 5.16, 95% CI: 1.32-20.17),and use of NIMV (OR: 5.08, 95% CI: 1.63-15.90)were independent predictors of ICU readmission.Conclusions: These findings highlight potential targets for risk stratification, warranting validation in larger, multicenter studies.