Acute and Critical Care

Original Articles

Trauma
Factors associated with unplanned intensive care unit readmission among trauma patients in Republic of Korea: Yongwoong Lee, Byung Hee Kang; Acute Crit Care. 2024;39(4):583-592. Published online November 22, 2024; DOI: https://doi.org/10.4266/acc.2024.00584

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Background
In trauma patients, unplanned intensive care unit (ICU) readmission (UIR) is associated with poor clinical outcomes. In this study, we aimed to analyze associated factors for UIR in trauma patients.
Methods
This retrospective study was conducted on trauma patients admitted to the ICU at a trauma center from January 2016 to December 2022. Clinical information at admission, the first ICU hospitalization, first discharge from the ICU, and reasons for readmission were collected. Patients who were successfully discharge from the ICU were compared to UIR patients. Logistic regression was performed to determine the factors with a significant impact on ICU readmission.
Results
Here, 5,529 patients were admitted to the ICU over 7 years, and 212 patients (3.8%) experienced UIR. Among patients who experienced UIR, 9 (4.2%) died. In the UIR patients, hospital stay (20 days [interquartile range, 13–35] vs. 45 days [28–67], P<0.001), total ICU stay (5 days [3– 11] vs. 17 days [9–35], P<0.001), and complications during the first ICU hospitalization were significantly higher. The most common reason for UIR was respiratory problem (53.8%). In multivariable analysis, cervical spine operation during the first ICU hospitalization (odds ratio, 6.56; 95% CI, 3.62–11.91; P<0.001), renal replacement therapy (RRT; 3.52, 2.06–5.99, P<0.001), and massive blood transfusion protocol (MTP; 1.74, 1.08–2.81, P=0.023) were most highly related with UIR.
Conclusions
Because UIR patients had poor outcomes, trauma patients who underwent cervical spine operation, RRT, or MTP require monitoring in the general ward, especially for respiratory problems.

Citations

Citations to this article as recorded by

Circulation-first trauma resuscitation and mortality: A 9-year single-center retrospective study
Donghwan Choi, Kyoungwon Jung
Journal of Trauma and Acute Care Surgery.2026; 100(4): 620. CrossRef
Unplanned intensive care unit admissions in trauma patients: A critical appraisal
Amlan Swain, Deb Sanjay Nag, Jayanta Kumar Laik, Seelora Sahu, Mrunalkant Panchal, Shivani Srirala
World Journal of Critical Care Medicine.2025;[Epub] CrossRef

Surgery
Risk factors for intensive care unit readmission after lung transplantation: a retrospective cohort study: Hye-Bin Kim, Sungwon Na, Hyo Chae Paik, Hyeji Joo, Jeongmin Kim; Acute Crit Care. 2021;36(2):99-108. Published online April 5, 2021; DOI: https://doi.org/10.4266/acc.2020.01144

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Abstract PDF

Background
Lung transplantation (LT) is an accepted therapeutic modality for end-stage lung disease patients. Intensive care unit (ICU) readmission is a risk factor for mortality after LT, for which consistent risk factors have not been elucidated. Thus, we investigated the risk factors for ICU readmission during index hospitalization after LT, particularly regarding the posttransplant condition of LT patients.
Methods
In this retrospective study, we investigated all adult patients undergoing LT between October 2012 and August 2017 at our institution. We collected perioperative data from electronic medical records such as demographics, comorbidities, laboratory findings, ICU readmission, and in-hospital mortality.
Results
We analyzed data for 130 patients. Thirty-two patients (24.6%) were readmitted to the ICU 47 times during index hospitalization. At the initial ICU discharge, the Sequential Organ Failure Assessment (SOFA) score (odds ratio [OR], 1.464; 95% confidence interval [CI], 1.083−1.978; P=0.013) and pH (OR, 0.884; 95% CI, 0.813−0.962; P=0.004; when the pH value increases by 0.01) were related to ICU readmission using multivariable regression analysis and were still significant after adjusting for confounding factors. Thirteen patients (10%) died during the hospitalization period, and the number of ICU readmissions was a significant risk factor for in-hospital mortality. The most common causes of ICU readmission and in-hospital mortality were infection-related.
Conclusions
The SOFA score and pH were associated with increased risk of ICU readmission. Early postoperative management of these factors and thorough posttransplantation infection control can reduce ICU readmission and improve the prognosis of LT patients.

Citations

Citations to this article as recorded by

Risk factors for survival after lung transplantation in cystic fibrosis: impact of colonization with multidrug-resistant strains of Pseudomonas aeruginosa
Bettina Weingard, Sören L. Becker, Sophie Schneitler, Franziska C. Trudzinski, Robert Bals, Heinrike Wilkens, Frank Langer
Infection.2025; 53(5): 1677. CrossRef
ICU Readmission and In-Hospital Mortality Rates for Patients Discharged from the ICU—Risk Factors and Validation of a New Predictive Model: The Worse Outcome Score (WOScore)
Eleftherios Papadakis, Athanasia Proklou, Sofia Kokkini, Ioanna Papakitsou, Ioannis Konstantinou, Aggeliki Konstantinidi, Georgios Prinianakis, Stergios Intzes, Marianthi Symeonidou, Eumorfia Kondili
Journal of Personalized Medicine.2025; 15(10): 479. CrossRef
The association of the Sequential Organ Failure Assessment score at intensive care unit discharge with intensive care unit readmission in the cardiac intensive care unit
Yonghoon Shin, Ji Hoon Jang, Ryoung-Eun Ko, Soo Jin Na, Chi Ryang Chung, Ki Hong Choi, Taek Kyu Park, Joo Myung Lee, Jeong Hoon Yang
European Heart Journal: Acute Cardiovascular Care.2024; 13(4): 354. CrossRef
Cardiothoracic Transplant Anesthesia: Selected Highlights: Part I—Lung Transplantation
Andrew M. Courtwright, Jagan Devarajan, Ashley Virginia Fritz, Archer Kilbourne Martin, Barbara Wilkey, Sudhakar Subramani, Christopher M. Cassara, Justin N. Tawil, Andrea N. Miltiades, Michael L. Boisen, Brandi A. Bottiger, Angela Pollak, Theresa A. Gelz
Journal of Cardiothoracic and Vascular Anesthesia.2023; 37(6): 884. CrossRef
Status and Risk Factors in Patients Requiring Unplanned Intensive Care Unit Readmission Within 48 Hours: A Retrospective Propensity-Matched Study in China
Yan-Ling Yin, Mei-Rong Sun, Kun Zhang, Yu-Hong Chen, Jie Zhang, Shao-Kun Zhang, Li-Li Zhou, Yan-Shuo Wu, Peng Gao, Kang-Kang Shen, Zhen-Jie Hu
Risk Management and Healthcare Policy.2023; Volume 16: 383. CrossRef
Comment on “Risk factors for intensive care unit readmission after lung transplantation: a retrospective cohort study”
Maida Qazi, Mahnoor Amin
Acute and Critical Care.2023; 38(2): 234. CrossRef
Reply to comment on “Risk factors for intensive care unit readmission after lung transplantation: a retrospective cohort study”
Hye-Bin Kim, Sungwon Na, Hyo Chae Paik, Hyeji Joo, Jeongmin Kim
Acute and Critical Care.2023; 38(2): 236. CrossRef
Predicting outcomes, describing complications and optimising rehabilitation in patients undergoing lung transplantation
Massimiliano Polastri, Gian Maria Paganelli
International Journal of Therapy and Rehabilitation.2023; 30(10): 1. CrossRef

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