Journal article
Patient-related factors associated with hospital discharge to a care facility after critical illness
American journal of critical care, Vol.20(5), pp.378-386
09/2011
DOI: 10.4037/ajcc2011827
PMCID: PMC3735167
PMID: 21885459
Abstract
Many critically ill patients are transferred to other care facilities instead of to home at hospital discharge.
To identify patient-related factors associated with hospital discharge to a care facility after critical illness and to estimate the magnitude of risk associated with each factor.
Retrospective cohort study of 548 survivors of critical illness in a medical intensive care unit. Multivariable logistic regression was used to identify independent risk factors for discharge to a care facility. Only the first 72 hours of intensive care were analyzed.
Approximately one-quarter of the survivors of critical illness were discharged to a care facility instead of to home. This event occurred more commonly in older patients, even after adjustment for severity of illness and comorbid conditions (odds ratio [OR] 1.8 for patients ≥ 65 years of age vs patients < 65 years; 95% confidence interval [CI], 1.1-3.1; P = .02). The risk was greatest for patients who received mechanical ventilation (OR, 3.4; 95% CI, 2.0-5.8; P < .001) or had hospitalizations characterized by severe cognitive dysfunction (OR, 8.1; 95% CI, 1.3-50.6; P = .02) or poor strength and/or mobility (OR, 31.7; 95% CI, 6.4-157.3; P < .001). The model showed good discrimination (area under the curve, 0.82; 95% CI, 0.77-0.86).
The model, which did not include baseline function or social variables, provided good discrimination between patients discharged to a care facility after critical illness and patients discharged to home. These results suggest that future research should focus on the debilitating effects of respiratory failure and on conditions with cognitive and neuromuscular sequelae.
Details
- Title: Subtitle
- Patient-related factors associated with hospital discharge to a care facility after critical illness
- Creators
- Brian K Gehlbach - Division of Pulmonary, Critical Care, and Occupational Medicine, University of Iowa, Iowa, USAVictor R SalamancaJoseph E LevittGreg A SachsMary Kate SweeneyAnne S PohlmanJeff CharbeneauJerry A KrishnanJesse B Hall
- Resource Type
- Journal article
- Publication Details
- American journal of critical care, Vol.20(5), pp.378-386
- Publisher
- United States
- DOI
- 10.4037/ajcc2011827
- PMID
- 21885459
- PMCID
- PMC3735167
- ISSN
- 1062-3264
- eISSN
- 1937-710X
- Grant note
- K23HL088020 / NHLBI NIH HHS K23 HL088020 / NHLBI NIH HHS
- Language
- English
- Date published
- 09/2011
- Academic Unit
- Neurology; Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
- Record Identifier
- 9984020846202771
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