Direct Discharge from the Critical Care Resuscitation Unit: Results from a Longitudinal Assessment.


Journal

Critical care research and practice
ISSN: 2090-1305
Titre abrégé: Crit Care Res Pract
Pays: Egypt
ID NLM: 101539357

Informations de publication

Date de publication:
2023
Historique:
received: 28 02 2023
revised: 20 07 2023
accepted: 07 10 2023
medline: 8 11 2023
pubmed: 8 11 2023
entrez: 8 11 2023
Statut: epublish

Résumé

The critical care resuscitation unit (CCRU) facilitates interhospital transfer (IHT) of critically ill patients for immediate interventions. Due to these patients' acuity, it is uncommon for patients to be directly discharged home from this unit, but it does happen on occasion. Since there is no literature regarding outcomes of patients being discharged from a resuscitation unit, our study investigated these patients' outcome at greater than 12 months after being discharged directly from the CCRU. We performed a retrospective cohort study of all adult patients directly discharged from the CCRU between January 01, 2017, and December 31, 2020. The primary outcome was number of ED visits or hospitalizations within 6 months. Secondary outcomes were number of ED visits or hospitalizations within 6, 12, and >12 months from CCRU discharge. We analyzed 145 patients' records. Mean age was 56 (standard deviation [SD] ± 19), with a majority being male (72%) and Caucasian (58%). The most common discharge destination was home (139 patients, 96% of total subjects) versus hospice (2%) or nursing facilities (2%). Most patients (55%) did not have any hospital revisits within the first 6 months of discharge, while 31% had 1-2 revisits, and 14% had ≥3 revisits. The most common discharge diagnoses were soft tissue infection (16.5%), aortic dissection (14%), and stroke (11%). Factors which were associated with a greater likelihood of any return hospital visit within 6 months receiving mechanical ventilation during CCRU stay (coefficient -2.23, 95% CI 0.01-0.87, Most patients who were discharged from the CCRU did not require any hospital revisits in the first 6 months. Requiring mechanical ventilation and having soft tissue infection were associated with high unplanned hospital revisits following discharge. Further research is needed to validate these findings.

Sections du résumé

Background UNASSIGNED
The critical care resuscitation unit (CCRU) facilitates interhospital transfer (IHT) of critically ill patients for immediate interventions. Due to these patients' acuity, it is uncommon for patients to be directly discharged home from this unit, but it does happen on occasion. Since there is no literature regarding outcomes of patients being discharged from a resuscitation unit, our study investigated these patients' outcome at greater than 12 months after being discharged directly from the CCRU.
Methods UNASSIGNED
We performed a retrospective cohort study of all adult patients directly discharged from the CCRU between January 01, 2017, and December 31, 2020. The primary outcome was number of ED visits or hospitalizations within 6 months. Secondary outcomes were number of ED visits or hospitalizations within 6, 12, and >12 months from CCRU discharge.
Results UNASSIGNED
We analyzed 145 patients' records. Mean age was 56 (standard deviation [SD] ± 19), with a majority being male (72%) and Caucasian (58%). The most common discharge destination was home (139 patients, 96% of total subjects) versus hospice (2%) or nursing facilities (2%). Most patients (55%) did not have any hospital revisits within the first 6 months of discharge, while 31% had 1-2 revisits, and 14% had ≥3 revisits. The most common discharge diagnoses were soft tissue infection (16.5%), aortic dissection (14%), and stroke (11%). Factors which were associated with a greater likelihood of any return hospital visit within 6 months receiving mechanical ventilation during CCRU stay (coefficient -2.23, 95% CI 0.01-0.87,
Conclusions UNASSIGNED
Most patients who were discharged from the CCRU did not require any hospital revisits in the first 6 months. Requiring mechanical ventilation and having soft tissue infection were associated with high unplanned hospital revisits following discharge. Further research is needed to validate these findings.

Identifiants

pubmed: 37937161
doi: 10.1155/2023/2213185
pmc: PMC10627715
doi:

Types de publication

Journal Article

Langues

eng

Pagination

2213185

Informations de copyright

Copyright © 2023 Quincy K. Tran et al.

Déclaration de conflit d'intérêts

The authors declare no conflicts of interest in this study.

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Auteurs

Quincy K Tran (QK)

Research Associate Program in Emergency Medicine and Critical Care, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
The R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA.
Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.

Austin Widjaja (A)

Research Associate Program in Emergency Medicine and Critical Care, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.

Anya Plotnikova (A)

Research Associate Program in Emergency Medicine and Critical Care, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.

Jerry Yang (J)

Research Associate Program in Emergency Medicine and Critical Care, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.

Jacob Epstein (J)

Research Associate Program in Emergency Medicine and Critical Care, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.

Alexa Aquino (A)

Research Associate Program in Emergency Medicine and Critical Care, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.

Fernando Albelo (F)

The R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA.

Taylor Kowansky (T)

The R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA.

Isha Vashee (I)

The R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA.

Samuel Austin (S)

The R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA.

Daniel J Haase (DJ)

The R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA.
Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.

Emily Esposito (E)

The R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA.
Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.

Classifications MeSH