Perioperative medicine & outcomes
The Effect of Readmission to the ICU on 60-Day Hospital Mortality in Patients With and Without Frailty: A Binational Registry-Based Study
Authors' conclusion
This large, multicenter, retrospective study found that ICU readmission was associated with increased 60-day mortality in patients with and without frailty. Readmitted patients with frailty had the greatest risk of 60-day mortality; however, frailty state did not modify the incremental absolute risk of death relative to nonreadmitted patients.
Study context
- Population
- Adults (≥ 18 yr) admitted to 203 ICUs in Australia and New Zealand, 2017–2022, with documented Clinical Frailty Scale
- Participants
- 615,719 ICU admission episodes
- Exposure
- ICU readmission vs no readmission, in patients with vs without frailty
- Outcome
- 60-day mortality
- Follow-up
- 60 days
Methodological detailsbinational, multicentre, time-dependent Cox model with frailty × readmission interaction, regression standardization, competing risk analysis
- Binational
- Multicentre
- Time-dependent Cox model with frailty × readmission interaction
- Regression standardization
- Competing risk analysis
Main finding
As reported in the abstract
Standardised risk increase in 60-day mortality associated with ICU readmission, patients with frailty
14.6%
95% CI 13.7–15.6%
Standardised risk increase in 60-day mortality associated with ICU readmission, patients without frailty
14.9%
95% CI 13.4–16.6%
Observed 60-day mortality greatest in frail, readmitted patients
22.7%
Observational data: associations, not effects.
Secondary outcomes
| Outcome | SHR (95% CI) | |
|---|---|---|
| ICU readmission, frail vs not frail (competing risk analysis)In-hospital death without readmission as competing risk | 1.10 (1.07–1.14) | |
| Death without readmission, frail vs not frail (competing risk analysis) | 2.83 (2.72–2.94) | |
| 0.20.5125Subdistribution hazard ratio (log scale) |
Cohort characteristics and overall 60-day in-hospital death
- Frail
- 19% (115,453)
- Readmitted to ICU
- 4.1% (25,329)
- Died in hospital by day 60
- 2.7% (16,353)
Original publication
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