Direct Discharge from the Critical Care Resuscitation Unit: Results from a Longitudinal Assessment
Background. 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 the...
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2023/2213185 |
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| author | Quincy K. Tran Austin Widjaja Anya Plotnikova Jerry Yang Jacob Epstein Alexa Aquino Fernando Albelo Taylor Kowansky Isha Vashee Samuel Austin Daniel J. Haase Emily Esposito |
| author_facet | Quincy K. Tran Austin Widjaja Anya Plotnikova Jerry Yang Jacob Epstein Alexa Aquino Fernando Albelo Taylor Kowansky Isha Vashee Samuel Austin Daniel J. Haase Emily Esposito |
| author_sort | Quincy K. Tran |
| collection | DOAJ |
| description | Background. 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. 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. 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, P=0.036), while high hemoglobin on CCRU discharge was associated with no ED revisit (coeff. 0.42, 95% CI 1.15–2.06, P=0.004). Conclusions. 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. |
| format | Article |
| id | doaj-art-bea8f8dbf4e84a4b9eadc5b4b0e3fe5c |
| institution | DOAJ |
| issn | 2090-1313 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-bea8f8dbf4e84a4b9eadc5b4b0e3fe5c2025-08-20T03:05:09ZengWileyCritical Care Research and Practice2090-13132023-01-01202310.1155/2023/2213185Direct Discharge from the Critical Care Resuscitation Unit: Results from a Longitudinal AssessmentQuincy K. Tran0Austin Widjaja1Anya Plotnikova2Jerry Yang3Jacob Epstein4Alexa Aquino5Fernando Albelo6Taylor Kowansky7Isha Vashee8Samuel Austin9Daniel J. Haase10Emily Esposito11Research Associate Program in Emergency Medicine and Critical CareResearch Associate Program in Emergency Medicine and Critical CareResearch Associate Program in Emergency Medicine and Critical CareResearch Associate Program in Emergency Medicine and Critical CareResearch Associate Program in Emergency Medicine and Critical CareResearch Associate Program in Emergency Medicine and Critical CareThe R. Adams Cowley Shock Trauma CenterThe R. Adams Cowley Shock Trauma CenterThe R. Adams Cowley Shock Trauma CenterThe R. Adams Cowley Shock Trauma CenterThe R. Adams Cowley Shock Trauma CenterThe R. Adams Cowley Shock Trauma CenterBackground. 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. 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. 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, P=0.036), while high hemoglobin on CCRU discharge was associated with no ED revisit (coeff. 0.42, 95% CI 1.15–2.06, P=0.004). Conclusions. 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.http://dx.doi.org/10.1155/2023/2213185 |
| spellingShingle | Quincy K. Tran Austin Widjaja Anya Plotnikova Jerry Yang Jacob Epstein Alexa Aquino Fernando Albelo Taylor Kowansky Isha Vashee Samuel Austin Daniel J. Haase Emily Esposito Direct Discharge from the Critical Care Resuscitation Unit: Results from a Longitudinal Assessment Critical Care Research and Practice |
| title | Direct Discharge from the Critical Care Resuscitation Unit: Results from a Longitudinal Assessment |
| title_full | Direct Discharge from the Critical Care Resuscitation Unit: Results from a Longitudinal Assessment |
| title_fullStr | Direct Discharge from the Critical Care Resuscitation Unit: Results from a Longitudinal Assessment |
| title_full_unstemmed | Direct Discharge from the Critical Care Resuscitation Unit: Results from a Longitudinal Assessment |
| title_short | Direct Discharge from the Critical Care Resuscitation Unit: Results from a Longitudinal Assessment |
| title_sort | direct discharge from the critical care resuscitation unit results from a longitudinal assessment |
| url | http://dx.doi.org/10.1155/2023/2213185 |
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