Abstract 4145943: Recidivism in the Cardiac Intensive Care Unit: Insights from the Multinational Critical Care Cardiology Trials Network
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Le résumé fourni par la source
Background: Intensive Care Unit (ICU) readmission, or recidivism, can lead to increased resource use, longer hospital length-of-stay (LOS), higher costs,&worse survival. Given the potential clinical&financial impact of recidivism, it may be a useful quality metric for unit-&hospital-level comparisons. No prior studies, however, have comprehensively explored recidivism – its potential causes or consequences – across Cardiac Intensive Care Units (CICUs). Methods: The Critical Care Cardiology Trials Network (CCCTN) is a multicenter registry of advanced CICUs coordinated by the TIMI Study Group (Boston, MA). Consecutive admissions were captured (n=16,705)&those with > 1 readmission during the same hospitalization were identified. Multivariable logistic regression was used to determine baseline variables associated with recidivism, as well as the association of recidivism with in-hospital mortality. Results: A total of 1287 pts (7.7%) had CICU readmission. These pts were younger (p=0.015), had more diabetes (p=0.04), prior heart failure (HF)&chronic kidney disease (CKD) (p<0.001 for both), more frequently presented with decompensated HF or cardiogenic shock (p<0.001), were more often transferred from outside facilities (p<0.001), and had higher Sequential Organ Failure Assessment (SOFA) scores at presentation (p<0.001). Rates of CICU recidivism highly varied across institutions ( Fig-A ). Compared to those who were not readmitted, those readmitted to the CICU had greater critical care resource use during their 1 st CICU stay ( Fig-B ), along with longer initial CICU LOS (2.8 vs 2.2d)&hospital LOS (20.4 vs 7.6d) (both p<0.001). Hospital mortality was 20.3% in those readmitted to the CICU compared to 4.5% in those without readmission ( Fig-C ); adjusted odds ratio 6.22 (95% CI 5.25-7.38, p<0.001). This remained statistically significant after adjustment for code status. Conclusions: CICU recidivism varies significantly across centers and is associated with numerous comorbidities, higher illness severity, and greater resource use. One of every 5 pts readmitted to the CICU died in the hospital. Recidivism should be measured in future CICU-based studies, and could help to assess quality of CICU care.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Abstract 4145943: Recidivism in the Cardiac Intensive Care Unit: Insights from the Multinational Critical Care Cardiology Trials Network
- Date Crossref
- 12/11/2024
- Éditeur
- Ovid Technologies (Wolters Kluwer Health)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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NYU Langone Health pays non établi dans la noticeÉtablissement de santé
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Alaska Heart and Vascular Institute pays non établi dans la noticeÉtablissement de santé
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Virginia Commonwealth University pays non établi dans la noticeUniversité ou école supérieure
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UC San Diego Health System pays non établi dans la noticeÉtablissement de santé
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Northwell Health pays non établi dans la noticeÉtablissement de santé
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Emory University pays non établi dans la noticeUniversité ou école supérieure
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Thrombolysis in Myocardial Infarction Study Group pays non établi dans la noticeStructure de recherche
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University of Alberta pays non établi dans la noticeUniversité ou école supérieure
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Brigham and Women's Hospital pays non établi dans la noticeÉtablissement de santé
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Inova Schar Heart and Vascular pays non établi dans la noticeInstitution
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Charleston pays non établi dans la noticeInstitution
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TIMI Study Group pays non établi dans la noticeInstitution
NYU Langone Health, Alaska Heart and Vascular Institute et Virginia Commonwealth University, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.