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Direct Discharge from the Critical Care Resuscitation Unit: Results from a Longitudinal Assessment
Quincy K Tran1,2,3, Austin Widjaja1, Anya Plotnikova1
1Research Associate Program in Emergency Medicine and Critical Care, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
Critical Care Research and Practice
|November 8, 2023
Summary
Most patients discharged from critical care resuscitation units (CCRU) do not need readmission. Mechanical ventilation during CCRU stay and soft tissue infection diagnosis were linked to higher revisit rates.
Area of Science:
- Critical Care Medicine
- Hospital Medicine
- Patient Outcomes Research
Background:
- Critical care resuscitation units (CCRU) manage critically ill patients requiring interhospital transfer (IHT).
- Direct discharge home from CCRU is uncommon but occurs.
- No prior literature exists on outcomes for patients discharged directly from CCRU.
Purpose of the Study:
- To investigate the outcomes of critically ill patients discharged directly from the CCRU.
- To analyze hospital revisit rates and associated factors at over 12 months post-discharge.
Main Methods:
- Retrospective cohort study of adult patients discharged directly from CCRU (2017-2020).
- Primary outcome: ED visits or hospitalizations within 6 months.
- Secondary outcomes: Revisit rates at 6, 12, and >12 months.
Main Results:
- 145 patients analyzed; 96% discharged home.
- 55% had no hospital revisits within 6 months.
- Mechanical ventilation during CCRU stay and soft tissue infection were associated with higher revisit rates.
Conclusions:
- The majority of CCRU direct discharges had no hospital revisits within 6 months.
- Mechanical ventilation and soft tissue infection predict higher unplanned revisits.
- Further research is needed to validate these findings.
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