Subjective score and outcomes after discharge from the intensive care unit: a prospective observational study

• Published in: Journal of international medical research Vol. 47; no. 9; pp. 4183 - 4193
• Main Authors: Taniguchi, Leandro Utino, Ramos, Fernando José da Silva, Momma, Arthur Khan, Martins Filho, Antônio Paulo Ramos, Bartocci, Juliana Jardim, Lopes, Maria Fernanda Dias, Sad, Matheus Horta, Rodrigues, Cinthia Mendes, Pires Siqueira, Ellen Maria, Vieira, José Mauro
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.09.2019; Sage Publications Ltd; SAGE Publishing
• Subjects: Aged; Clinical Research Reports; Female; Health risk assessment; Humans; Intensive care; Intensive Care Units; Male; Multivariate Analysis; Observational studies; Patient Discharge; Prospective Studies; Sepsis; Survival Analysis; Treatment Outcome; oncology service; intensive care unit; hospital; Sabadell score; Patient readmission; risk factor
• ISSN: 0300-0605; 1473-2300
• DOI: 10.1177/0300060519859736

Objective Intensive care unit (ICU) discharge is a decision process that is usually performed subjectively. We evaluated whether a subjective score (Sabadell score) is associated with hospital outcomes. Methods We conducted a prospective cohort study from August 2014 to May 2015 at a tertiary-care private hospital in Brazil. We analyzed 425 patients who were discharged alive from the ICU to the wards. We used univariate and multivariate analysis to identify risk factors associated with a composite endpoint of worse outcomes (later ICU readmission or ward death) during the same hospitalization. Results Forty-three patients (10.1%) were readmitted after ICU discharge, and 19 died in the ward. Compared with patients with successful outcomes, those with the composite endpoint were older and more severely ill, had a nonsurgical reason for hospitalization, more frequently came from the ward, were less frequently independent during daily activities, had sepsis, had higher C-reactive protein concentrations at ICU admission, and had higher Sabadell scores at discharge. The multivariate analysis showed that sepsis and the Sabadell score were independently and significantly associated with worse outcomes. Conclusion Sepsis at admission and the Sabadell score were predictors of worse hospital outcomes. The Sabadell score might be a promising predictive tool.