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


Authors: Chawla, S.; D'agostino, R. L.; Pastores, S. M.; Thirumala, R.; Kostelecky, N.; Chou, J. F.; Thaler, H. T.; Halpern, N. A.
Article Title: Homeward bound: An analysis of patients discharged home from an oncologic intensive care unit
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. © 2012 Elsevier Inc.
Keywords: adult; treatment outcome; major clinical study; clinical feature; gastrointestinal hemorrhage; demography; heart disease; patient assessment; retrospective study; cancer mortality; intensive care; intensive care unit; length of stay; clinical evaluation; sepsis; hospital discharge; hospital readmission; trend study; home care; outcomes; critical care; respiratory failure; occupancy; oncology ward; discharge; home; hospice patient; human characteristic
Journal Title: Journal of Critical Care
Volume: 27
Issue: 6
ISSN: 0883-9441
Publisher: W.B. Saunders Co.  
Date Published: 2012-12-01
Start Page: 681
End Page: 687
Language: English
DOI: 10.1016/j.jcrc.2012.05.009
PROVIDER: scopus
PUBMED: 22901403
DOI/URL:
Notes: --- - "Export Date: 2 January 2013" - "CODEN: JCCAE" - "Source: Scopus"
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MSK Authors
  1. Joanne Fu-Lou Chou
    149 Chou
  2. Sanjay Chawla
    16 Chawla
  3. Neil A Halpern
    111 Halpern
  4. Stephen Pastores
    142 Pastores
  5. Natalie Theresa Remor
    21 Remor
  6. Howard T Thaler
    190 Thaler