Subjective score and outcomes after discharge from the intensive care unit: a prospective observational study
- PMID: 31304841
- PMCID: PMC6753551
- DOI: 10.1177/0300060519859736
Subjective score and outcomes after discharge from the intensive care unit: a prospective observational study
Abstract
Objective: Intensive care unit (ICU) discharge is a decision process that is usually performed subjectively. We evaluated whether a subjective score (Sabadell score) is associated with hospital outcomes.
Methods: We conducted a prospective cohort study from August 2014 to May 2015 at a tertiary-care private hospital in Brazil. We analyzed 425 patients who were discharged alive from the ICU to the wards. We used univariate and multivariate analysis to identify risk factors associated with a composite endpoint of worse outcomes (later ICU readmission or ward death) during the same hospitalization.
Results: Forty-three patients (10.1%) were readmitted after ICU discharge, and 19 died in the ward. Compared with patients with successful outcomes, those with the composite endpoint were older and more severely ill, had a nonsurgical reason for hospitalization, more frequently came from the ward, were less frequently independent during daily activities, had sepsis, had higher C-reactive protein concentrations at ICU admission, and had higher Sabadell scores at discharge. The multivariate analysis showed that sepsis and the Sabadell score were independently and significantly associated with worse outcomes.
Conclusion: Sepsis at admission and the Sabadell score were predictors of worse hospital outcomes. The Sabadell score might be a promising predictive tool.
Keywords: Patient readmission; Sabadell score; hospital; intensive care unit; oncology service; risk factor.
Figures
Similar articles
-
A modified McCabe score for stratification of patients after intensive care unit discharge: the Sabadell score.Crit Care. 2006;10(6):R179. doi: 10.1186/cc5136. Crit Care. 2006. PMID: 17192174 Free PMC article.
-
Does the implementation of a novel intensive care discharge risk score and nurse-led inpatient review tool improve outcome? A prospective cohort study in two intensive care units in the UK.BMJ Open. 2017 Dec 26;7(12):e018322. doi: 10.1136/bmjopen-2017-018322. BMJ Open. 2017. PMID: 29282265 Free PMC article.
-
Intensive care unit discharge to the ward with a tracheostomy cannula as a risk factor for mortality: a prospective, multicenter propensity analysis.Crit Care Med. 2011 Oct;39(10):2240-5. doi: 10.1097/CCM.0b013e3182227533. Crit Care Med. 2011. PMID: 21670665
-
Ward mortality after ICU discharge: a multicenter validation of the Sabadell score.Intensive Care Med. 2010 Jul;36(7):1196-201. doi: 10.1007/s00134-010-1825-5. Epub 2010 Mar 11. Intensive Care Med. 2010. PMID: 20221748
-
High occupancy increases the risk of early death or readmission after transfer from intensive care.Crit Care Med. 2009 Oct;37(10):2753-8. doi: 10.1097/CCM.0b013e3181a57b0c. Crit Care Med. 2009. PMID: 19707139
Cited by
-
Risk factors for hospital mortality in intensive care unit survivors: a retrospective cohort study.Acute Crit Care. 2023 Feb;38(1):68-75. doi: 10.4266/acc.2022.01375. Epub 2023 Feb 27. Acute Crit Care. 2023. PMID: 36935536 Free PMC article.
-
Factors Influencing the Decision-making of Healthcare Providers Regarding the Transition of Patients from the Intensive Care Unit to the General Ward in Iran: A Qualitative Study.Indian J Crit Care Med. 2022 May;26(5):568-573. doi: 10.5005/jp-journals-10071-24211. Indian J Crit Care Med. 2022. PMID: 35719458 Free PMC article.
-
Predictive Modeling for Readmission to Intensive Care: A Systematic Review.Crit Care Explor. 2023 Jan 6;5(1):e0848. doi: 10.1097/CCE.0000000000000848. eCollection 2023 Jan. Crit Care Explor. 2023. PMID: 36699252 Free PMC article. Review.
References
-
- Angus DC, Carlet J, Brussels Roundtable P. Surviving intensive care: a report from the 2002 Brussels Roundtable. Intensive Care Med 2003; 29: 368–377. - PubMed
-
- Campbell AJ, Cook JA, Adey G, et al. Predicting death and readmission after intensive care discharge. Br J Anaesth 2008; 100: 656–662. - PubMed
-
- Ponzoni CR, Correa TD, Filho RR, et al. Readmission to the Intensive Care Unit: incidence, risk factors, resource use, and outcomes. A retrospective cohort study. Ann Am Thorac Soc 2017; 14: 1312–1319. - PubMed
-
- Kruse JA, Thill-Baharozian MC, Carlson RW. Comparison of clinical assessment with APACHE II for predicting mortality risk in patients admitted to a medical intensive care unit. JAMA 1988; 260: 1739–1742. - PubMed
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Research Materials