Incidence, risk and impact of unplanned ICU readmission on patient outcomes and resource utilisation in tertiary level ICUs in Nepal.

The study assesses the determinants of risk attributable to unplanned ICU readmission in four ICUs in Kathmandu, Nepal. Despite growing literature on this topic, most of the evidence on incidence, characteristics, associated risk factors and attributable outcomes of unplanned readmission to ICU are from studies performed in high-income countries. In this study, the registry-embedded eCRF reported data on case mix, severity of illness, in-ICU interventions (including organ support), ICU outcome, and readmission characteristics. Data were captured in all adult patients admitted between September 2019 and February 2021. Population and ICU encounter characteristics were compared between those with and without readmission. Independent risk factors for readmission were assessed using univariate analysis. Unplanned ICU readmission rates were adversely associated with significantly poorer outcomes, increased ICU resource utilisation. Clinical and organisational characteristics influenced risk of readmission and outcome.本研究旨在评估尼泊尔加德满都四家重症监护室（Intensive Care Unit, ICU）中非计划ICU再入院的可归因风险影响因素。尽管该领域的研究文献日益丰富，但目前有关ICU非计划再入院的发生率、临床特征、相关危险因素及可归因结局的绝大多数证据，均来自高收入国家开展的研究。本研究依托嵌入登记系统的电子病例报告表（electronic Case Report Form, eCRF），采集了患者病例组合、病情严重程度、ICU内干预措施（含器官支持）、ICU结局及再入院特征等相关数据。研究纳入2019年9月至2021年2月期间收治的全部成年患者，并对发生再入院与未发生再入院的患者人群及ICU就诊特征开展对比分析。本研究采用单变量分析法，评估了患者再入院的独立危险因素。非计划ICU再入院率与更差的临床结局及更高的ICU资源消耗呈显著负相关。临床与组织管理特征会对患者再入院风险及临床结局产生显著影响。