Objective: To analyze the factors which influence the mortality of patients transferred or re-admitted to intensive care unit (ICU), and investigate the method to decrease mortality of patients in ICU.
Methods: The patients died in ICU from November 2002 to October 2004 were divided into three groups: control group (n=39), transferred group (n=25) and re-admitted group (n=23). The acute physiology and chronic health evaluation II(APACHEII) score, causes of death and therapeutic protocol of each patient were studied.
Results: The total mortality of patients in control group was lower than those of transferred and re-admitted group within 48 hours after admission to ICU (both P<0.05). The top three main causes of death were hemorrhagic shock/severe trauma, central nervous system (CNS) injury or disease and cardiac failure in control group, and sepsis, respiratory failure, cardiac failure or hemorrhagic shock/severe trauma in transferred group, and respiratory failure, cardiac failure and sepsis in re-admitted group. Among the three groups, APACHEII scores on admission of each group [(18.67+/-3.28) scores, (20.84+/-4.16) scores, and (20.39+/-3.15) scores, respectively] were obviously higher than the mean value of other patients admitted to ICU [(4.28+/-1.52) scores, all P<0.01]. The scores of re-admitted patients at the time of discharge from ICU [(12.83+/-2.76) scores] were also obviously higher than the mean value of other patients discharged from ICU [(3.28+/-3.42) scores, P<0.01].
Conclusion: It is important to emphasize to monitor the circulation or respiration and early intervention of critical patients, to improve the clinical evaluation of the patients discharged from ICU, in order to decrease the mortality of patients re-admitted to ICU.