The APACHE-II score and the effect of discharge practices on readmission and mortality in intensive care patients
Abstract
Background: Two undesirable conditions after discharge from the intensive care unit (ICU) are need of readmission to the ICU and death. Many causative factors have been extensively studied by the researchers in different countries at different periods. We evaluated the effect of APACHE II score on admission and the discharge practices on readmission and mortality.
Methodology: A total of 342 patients were hospitalized in a tertiary ICU between January 2020 and April 2021. We, retrospectively, retrieved their demographic information, and recorded the length of stay in the hospital and ICU, inotropic support, need and duration of mechanical ventilation, units from which the patients were admitted, from which units they were discharged. History of readmission, hospitalization in the ICU, and one-month mortality were also recorded retrospectively.
Results: In our study, no significant difference was found between hospitalization APACHE II scores and post-discharge mortality and readmission rates. It was determined that one-month mortality was significantly higher in the group of patients admitted from the ward. Patients admission to palliative care, and inotropic support was a factor associated with one-month mortality. Prolonged hospital stay was a factor associated with readmission to the ICU.
Conclusion: As prolongation of the time spent in the service of ICU patients may increase ICU mortality, precautions should be taken. Appropriately timed discharge from the medical ward to the ICU and from the ICU to other units will reduce both ICU readmission and mortality.
Abbreviations: APACHE II- Acute Physıology And Chronıc Health Evaluatıon II Score; CRRT- Continuous Renal Replacement Therapy; SOFA- Sequential Organ Failure Evaluation score, CCIS-Charlson Comorbidity Index Score
Keywords: APACHE, Discharge, Intensive care, Mortality, Readmission
Citation: Doganci M, Doganay GE. The APACHE-II score and the effect of discharge practices on readmission and mortality in intensive care patients. Anaesth. pain intensive care 2024;28(2):214−220; DOI: 10.35975/apic.v28i2.2424
Received: September 10, 2023; Revised: February 21, 2024; Accepted: February 21, 2024
