Informacja

Drogi użytkowniku, aplikacja do prawidłowego działania wymaga obsługi JavaScript. Proszę włącz obsługę JavaScript w Twojej przeglądarce.

Tytuł pozycji:

Survival and Safety Outcomes of ICU Patients Discharged Directly Home-A Direct From ICU Sent Home Study.

Tytuł:
Survival and Safety Outcomes of ICU Patients Discharged Directly Home-A Direct From ICU Sent Home Study.
Autorzy:
Lau VI; Department of Medicine, Division of Critical Care, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Lam JNH; Department of Medicine, Division of Critical Care, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Basmaji J; Department of Medicine, Division of Critical Care, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Priestap FA; Department of Medicine, Division of Critical Care, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Ball IM; Department of Medicine, Division of Critical Care, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.; Department of Epidemiology and Biostatistics, Western University, London, ON, Canada.
Źródło:
Critical care medicine [Crit Care Med] 2018 Jun; Vol. 46 (6), pp. 900-906.
Typ publikacji:
Journal Article
Język:
English
Imprint Name(s):
Publication: Philadelphia, PA : Lippincott Williams & Wilkins
Original Publication: New York, Kolen.
MeSH Terms:
Intensive Care Units*
Patient Discharge*
Adult ; Female ; Humans ; Male ; Middle Aged ; Mortality ; Patient Readmission/statistics & numerical data ; Prospective Studies ; Survival Analysis ; Tertiary Care Centers
Entry Date(s):
Date Created: 20180302 Date Completed: 20190919 Latest Revision: 20220408
Update Code:
20240104
DOI:
10.1097/CCM.0000000000003074
PMID:
29494475
Czasopismo naukowe
Objectives: Evaluate outcomes (mortality, morbidity, unplanned return visits) of patients who are discharged directly to home from the ICU.
Design: Prospective cohort study.
Setting: Two tertiary care medical-surgical-trauma ICUs at Canadian hospitals over 1 year (February 2016-2017).
Subjects: All adult patients who were either discharged directly to home (Recruited and Nonrecruited cohorts) from ICU or discharged home within 24 hours after ward transfer (Ward Transfer cohort).
Interventions: Direct discharge home from ICU or discharge home within 24 hours of ward transfer from ICU.
Measurements and Main Results: One-hundred ninety-eight patients were in the study, 100 patients in the discharged directly to home Recruited arm, 37 patients in the discharged directly to home Nonrecruited arm, and 61 patients in the Ward cohort. All three patient cohorts had 0% mortality at 8 weeks post discharge. The unplanned return visit rate for the Recruited cohort was 24% (emergency department 18%, Ward 4%, ICU 1%), whereas the rate for the Nonrecruited cohort was 52% (emergency department 34%, Ward 14%, ICU 3%) and the Ward Transfer cohort was 46% (emergency department 17%, Ward 26%, ICU 3%) (p = 0.005). No home support was available for 7% of the discharged directly to home Recruited cohort. Twenty-four percent of patients had funded home care nursing, but the majority of patients (81%) relied on help from friends/family.
Conclusions: Recruited discharged directly to home patients experienced very good 8-week postdischarge outcomes with 0% mortality and a low rate of ICU readmission (1%) or ward readmission (4%), but not an insignificant rate of emergency department visits (18%). Recruited discharged directly to home patients had better outcomes compared with nonrecruited discharged directly to home patients and patients transferred briefly to the ward prior to discharge home. Future work should include derivation of a clinical prediction tool to identify patient characteristics that make discharged directly to home safe and a randomized control trial to compare discharged directly to home with short stay ward transfers.
Comment in: Crit Care Med. 2018 Jun;46(6):1015-1016. (PMID: 29762403)

Ta witryna wykorzystuje pliki cookies do przechowywania informacji na Twoim komputerze. Pliki cookies stosujemy w celu świadczenia usług na najwyższym poziomie, w tym w sposób dostosowany do indywidualnych potrzeb. Korzystanie z witryny bez zmiany ustawień dotyczących cookies oznacza, że będą one zamieszczane w Twoim komputerze. W każdym momencie możesz dokonać zmiany ustawień dotyczących cookies