The Stability and Workload Index for Transfer score predicts unplanned intensive care unit patient readmission: initial development and validation

Critical Care Medicine
Ognjen GajicJ Christopher Farmer

Abstract

Unplanned readmission of hospitalized patients to an intensive care unit (ICU) is associated with a worse outcome, but our ability to identify who is likely to deteriorate after ICU dismissal is limited. The objective of this study is to develop and validate a numerical index, named the Stability and Workload Index for Transfer, to predict ICU readmission. In this prospective cohort study, risk factors for ICU readmission were identified from a broad range of patients' admission and discharge characteristics, specific ICU interventions, and in-patient workload measurements. The prediction score was validated in two independent ICUs. One medical and one mixed medical-surgical ICU in two tertiary centers. Consecutive patients requiring >24 hrs of ICU care. None. Unplanned ICU readmission or unexpected death following ICU dismissal. In a derivation cohort of 1,131 medical ICU patients, 100 patients had unplanned readmissions, and five died unexpectedly in the hospital following ICU discharge. Predictors of readmission/unexpected death identified in a logistic regression analysis were ICU admission source, ICU length of stay, and day of discharge neurologic (Glasgow Coma Scale) and respiratory (hypoxemia, hypercapnia, or nursing re...Continue Reading

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