Homeward bound: An analysis of patients discharged home from an oncologic intensive care unit

Sanjay Chawla, Rhonda L. D'Agostino, Stephen M. Pastores, Raghukumar Thirumala, Natalie Kostelecky, Joanne F. Chou, Howard T. Thaler, Neil A. Halpern

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Purpose: The objectives of our study were to evaluate the characteristics and outcomes of patients discharged home directly from an oncologic intensive care unit (ICU) and their 30-day hospital readmission patterns. Materials and Methods: We retrospectively reviewed ICU discharges over 3 years (2008-2010) and identified patients who were discharged directly home. Demographic, clinical, ICU discharge, and 30-day hospital readmission and mortality rates were analyzed. Results: Ninety-five patients (3.6%) were discharged home directly from the ICU (average annual rate of 3.9%). ICU diagnoses primarily included respiratory insufficiency, sepsis, cardiac syndromes, and gastrointestinal bleeding. Home discharge occurred most commonly between Thursday and Saturday. Five (5.3%) patients, including 2 hospice patients, died within 30 days of ICU home discharge. Thirty (31.6%) patients were readmitted within 30 days of discharge. The unplanned 30-day readmission rate was 23.2% (22/95) with a median time to hospital readmission of 13 (8-18) days. Most (64%) of the unplanned readmissions were related to the initial ICU admission. Conclusions: Home discharge of ICU patients at our institution is infrequent but consistent. Almost one third of these patients were readmitted to the hospital within 30 days. Enhancements to the ICU home discharge process may be required to ensure optimal post-ICU care.

Original languageEnglish
Pages (from-to)681-687
Number of pages7
JournalJournal of Critical Care
Volume27
Issue number6
DOIs
StatePublished - Dec 2012
Externally publishedYes

Keywords

  • Cancer
  • Critical care
  • Discharge
  • Home
  • Intensive care
  • Occupancy
  • Outcomes

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