Predicting ICU readmission of surgical patients

Editor's Note

ICU readmission risk for surgical patients can be predicted using a simple, clinical nomogram based on seven demographic and physiologic variables, this study finds.

Of 3,109 patients admitted to the ICU by general surgery, transplant, trauma, and vascular surgery services, there were 141 (5%) unplanned readmissions within 72 hours.

The variables of age, blood urea nitrogen, serum chloride, serum glucose, atrial fibrillation, renal insufficiency, and respiratory rate were used to develop a clinical nomogram. The nomogram was then prospectively assessed to evaluate the correlation between perceived and calculated risk for ICU readmission.

Prospective assessment showed ICU providers’ perception of respiratory risk was moderately correlated with calculated risk using the nomogram. Perceptions of electrolyte abnormalities, hyperglycemia, renal insufficiency, and risk for arrhythmias were not correlated with measured values.

The findings underscore the potential for risk calculators to combine multiple risk factors and enable a more accurate risk assessment beyond perception alone, the researches say.