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ICU READMISSION OF TRACHEOSTOMIZED PATIENTS: AN ANALYSIS OF PREDICTORS

Robert Wood Johnson Medical School-Camden Campus, Camden, NJ

PURPOSE: ICU readmission has been associated with a hospital stay twice as long1 and a mortality rate ten times greater as compared to non-readmission stays1. In our experience, we noted a high incidence of ICU readmission in tracheostomized patients. Clinical predictors for readmission in this group have not yet been established.

METHODS: We retrospectively reviewed our database for tracheostomized patients from 2004–2006.

RESULTS: Fifty patients underwent tracheostomy during this two year period. The overall Readmission rate was 28%. Fourteen patients were readmitted; including 3 who died after readmission, while 21 others were not readmitted. Nine patients died during the first ICU admission, 6 patients died on medical floors. We looked at the classic risk factors associated with higher mortality and readmission rates (table). None of those factors showed any significant associations with higher rate of ICU readmission.

CONCLUSION: This retrospective analysis, although unable to show clinical predictors for ICU readmission of tracheostomized patients, has shown that the readmission rate of these patients is higher than non-tracheostomized patients (4–10% 2). This higher readmission rate may be the reflection of the degree of compromise of these patients leading in fact to the need of tracheostomy.The already established ICU readmission predictors of non tracheostomized patients did not apply to tracheostomized patients. This could be explained by the limited number of patients in this study or by the fact that tracheostomy may have changed the profile of these patients.

CLINICAL IMPLICATIONS: Further and larger studies are needed in order to determine clinical predictors of readmission of this group of patient requiring more often ICU readmission than others.

DISCLOSURE: Wissam Abouzgheib, No Financial Disclosure Information; No Product/Research Disclosure Information