TY - JOUR
T1 - The Epidemiology of ICU Readmissions Across Ten Health Systems
AU - Amagai, Saki
AU - Chaudhari, Vaishvik
AU - Chhikara, Kaveri
AU - Ingraham, Nicholas E.
AU - Hochberg, Chad H.
AU - Barker, Anna K.
AU - Mao, Chengsheng
AU - Ortiz, Alexander C.
AU - Weissman, Gary E.
AU - Schmid, Benjamin E.
AU - Schwinne, Megan
AU - Bhavani, Sivasubramanium V.
AU - Guleria, Shan
AU - Liao, Zewei
AU - Markov, Nikolay
AU - Lyons, Patrick G.
AU - Park-Egan, Brenna
AU - Parker, William F.
AU - Luo, Yuan
AU - Rojas, Juan C.
AU - Gao, Catherine A.
N1 - Publisher Copyright:
© 2025 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.
PY - 2025
Y1 - 2025
N2 - ICU readmissions remain a critical concern, carrying increased morbidity, mortality, and cost. We examined the epidemiology of unplanned ICU readmissions across 19 hospitals in the Common Longitudinal ICU data Format (CLIF) Consortium from January 2020 to December 2021 and the MIMIC-IV database. The cohort included 185, 241 adult ICU admissions, excluding postoperative or post-interventional procedure readmissions. Overall, 8.6% of ICU discharges were readmitted during the same hospitalization. Unplanned readmissions occurred in 1.9% of cases within 24 hours, 3.4% within 48 hours, and 4.5% within 72 hours of discharge. Readmitted patients experienced markedly higher in-hospital mortality (20.6% vs. 2.1%; p < 0.001). Compared with initial ICU stays, readmissions were associated with greater use of respiratory support (42.3% vs. 35.3%) and vasopressors (26.1% vs. 23.1%). Hospitals with stepdown units demonstrated comparable unplanned ICU readmission rates. These findings demonstrate that ICU readmissions remain common, are associated with poor outcomes, and require greater organ support. Improved characterization of high-risk subphenotypes is needed to inform safer discharge processes.
AB - ICU readmissions remain a critical concern, carrying increased morbidity, mortality, and cost. We examined the epidemiology of unplanned ICU readmissions across 19 hospitals in the Common Longitudinal ICU data Format (CLIF) Consortium from January 2020 to December 2021 and the MIMIC-IV database. The cohort included 185, 241 adult ICU admissions, excluding postoperative or post-interventional procedure readmissions. Overall, 8.6% of ICU discharges were readmitted during the same hospitalization. Unplanned readmissions occurred in 1.9% of cases within 24 hours, 3.4% within 48 hours, and 4.5% within 72 hours of discharge. Readmitted patients experienced markedly higher in-hospital mortality (20.6% vs. 2.1%; p < 0.001). Compared with initial ICU stays, readmissions were associated with greater use of respiratory support (42.3% vs. 35.3%) and vasopressors (26.1% vs. 23.1%). Hospitals with stepdown units demonstrated comparable unplanned ICU readmission rates. These findings demonstrate that ICU readmissions remain common, are associated with poor outcomes, and require greater organ support. Improved characterization of high-risk subphenotypes is needed to inform safer discharge processes.
KW - critical care outcomes
KW - discharge risk stratification
KW - hospital mortality
KW - intensive care unit readmission
KW - organ support utilization
UR - https://www.scopus.com/pages/publications/105026551591
UR - https://www.scopus.com/pages/publications/105026551591#tab=citedBy
U2 - 10.1097/CCE.0000000000001341
DO - 10.1097/CCE.0000000000001341
M3 - Letter
C2 - 41165278
AN - SCOPUS:105026551591
SN - 2639-8028
VL - 7
SP - e1341
JO - Critical Care Explorations
JF - Critical Care Explorations
IS - 11
ER -