Tag: discharge

Upvote Story 3
The use of ICU diaries in the PICU setting is feasible and perceived as beneficial by families of critically ill children. Future studies are needed to better understand if PICU diaries may objectively improve psychologic outcomes of patients and family members after PICU admission. Twenty families of critically ill children admitted to the PICU were enrolled in the PICU diary pilot study between May 2017... Read More | Comment
Upvote Story 8
In mechanically ventilated patients enrolled in a randomized clinical trial of early mobilization, the use of vasoactive medications was independently associated with the development of ICU-acquired weakness. Prospective trials to further evaluate this relationship are merited. On logistic regression analysis, the use of vasoactive medications increased the odds of developing ICU-acquired weakness (odds ratio [OR], 3.2; P = .01) independent of all other established risk... Read More | Comment
Upvote Story 4
Post-intensive care syndrome (PICS) describes new or worsening impairments of physical, cognitive or mental health resulting from an episode of critical illness and its treatment and lasting after discharge from the intensive care unit (ICU). The incidence of PICS varies based on the domain impacted, ranging from up to 25% for physical and cognitive and up to 60% for psychiatric disturbances. Even as we continue... Read More | Comment
Upvote Story 5
The trajectory of recovery from critical illness is often portrayed as a continuum. At one extremity lies an unstable patient dependent on life-sustaining treatments in the intensive care unit. At the other extremity stands an independent community-dwelling individual with restored personal, social and cultural wellbeing. A progressive transition from illness to recovery reflected by gradual de-intensification of healthcare occurs over many weeks to months. This... Read More | Comment
Upvote Story 11
In this prospective cohort study of Danish ICU patients, we found significantly reduced cognitive function for intensive care patients 3 and 12 months after discharge. We included 161 patients, 79 patients had a 3-month and 53 a 12-month follow-up visit. The primary reasons for not being visited at 3-month were death (44 patients), decline (26 patients), or transferal to another ICU (6 patients). Three and... Read More | Comment
Upvote Story 5
Males had an increased likelihood of receiving Bystander Cardiopulmonary Resuscitation (BCPR) compared with females in public. BCPR improved survival to discharge, with greater survival among males compared with females. Analyzed data from adult, nontraumatic OHCA events within the Resuscitation Outcomes Consortium registry (2011–2015). Using logistic regression, we modeled the likelihood of receiving BCPR by gender, including patient-level variables, stratified by location. A cohort of 19 331... Read More | Comment
Upvote Story 5
Discharging patients home directly from the intensive care unit (ICU) is associated with outcomes similar to those seen in patients discharged after a follow-up stay on a hospital ward, the authors of a large, population-based study say. The groups did not differ for hospital readmission or emergency department visits at 30 days or for 1-year mortality. The discharge of select adult patients directly home from... Read More | Comment
Upvote Story 15
The discharge of select adult patients directly home from the ICU is common, and it is not associated with increased health care utilization or increased mortality. Among the 6732 patients included in the study, 2826 (42%) were female; median age, 56 years (interquartile range, 41-67 years); 922 (14%) were discharged directly home, with significant variation found between hospitals (range, 4.4%-44.0%). The primary outcome was readmission... Read More | Comment
Upvote Story 4
Oral phenytoin loading can be achieved in a single dose, obviating the need for an IV while still achieving quick administration, adequate serum levels, and minimal side effects. Both the immediate release (suspension or chewable tablet) and extended release (phenytoin sodium ER capsule) products have been used successfully. IV loading does achieve quicker therapeutic level (3 hours), so there may still be a risk of... Read More | Comment
Upvote Story 5
Out-of-hours discharge from an ICU is strongly associated with both in-hospital death and ICU readmission. These effects persisted across all definitions of “out of hours” and across healthcare systems in different geographical locations. Whether these increases in mortality and readmission result from patient differences, differences in care, or a combination remains unclear. Our searches identified 1961 studies. We included unadjusted data from 1,191,178 patients from... Read More | Comment
Upvote Story 7
Innovations in workforce training and technology specific to the ICU may be useful in addressing the shortage of intensivist physicians, yielding benefits to patients and payers. Implementation of the advanced practice provider residency program and tele‐ICU was associated with a significant reduction in average Medicare spending per episode. Read More | Comment
Upvote Story 9
There was an increased risk of death in a cohort of ICU-admitted children even 3 years after discharge. In those who survived 30 days after discharge, medical causes of death were dominant, whereas deaths due to trauma were most common in the control group. The mortality and causes of death following ICU discharge were analyzed retrospectively. The median follow-up period was 4.9 years (25–75th percentiles,... Read More | Comment
Upvote Story 7
Recruited discharged directly to home patients experienced very good 8-week postdischarge outcomes with 0% mortality and a low rate of ICU readmission (1%) or ward readmission (4%), but not an insignificant rate of emergency department visits (18%). Recruited discharged directly to home patients had better outcomes compared with nonrecruited discharged directly to home patients and patients transferred briefly to the ward prior to discharge home.... Read More | Comment
Upvote Story 7
Discharge instructions for VTE have typically included medication management recommendations related to the use of warfarin. In recent years, however, a growing number of alternatives to warfarin, such as direct oral anticoagulants (DOACs) and other anticoagulants are being more widely used. These medications eliminate many of the complex monitoring challenges associated with warfarin, but are not without safety concerns. Since January 1, 2017, Joint Commission... Read More | Comment
Upvote Story 11
Severe illness predisposes ICU patients to readmission, especially when goals of care were not adequately addressed. Communication, premature discharge, and other factors, mostly unrelated to the patient were also perceived by physicians and nurses to be associated with readmissions to intensive care. Quality improvement efforts that focus on modifying or improving aspects of non-patient factors may improve outcomes for patients at risk of ICU readmission. Read More | Comment
Upvote Story 13
A significant number of intensive care unit survivors evaluated 3 months after discharge had psychological, respiratory, motor, and socioeconomic problems; these findings highlight that strategies aimed to assist critically ill patients should be extended to the post-hospitalization period and that this problem is particularly important in low-income populations. A total of 688 out of 1945 intensive care unit survivors received care at the clinic. Of... Read More | Comment
Upvote Story 8
A new study published in the journal Critical Care Medicine finds that a biomarker may help identify which family members will be most emotionally impacted by their loved one’s ICU stay. In particular, family members who showed a morning spike in cortisol were more likely to still be suffering from anxiety three months later. Cortisol is known as the “stress hormone,” because it can spike... Read More | Comment
Upvote Story 6
Many patients suffer significant physical, social and psychological problems in the months and years following critical care discharge. At present, there is minimal evidence of any effective interventions to support this patient group following hospital discharge. The aim of this project was to understand the impact of a complex intervention for ICU survivors. Read More | Comment
Upvote Story 3
A consensus-based framework for optimal physical therapy (PT) after hospital discharge is proposed. Future research should focus on feasibility testing of this framework, developing risk stratification tools and validating core outcome measures for ICU survivors. Ten internationally established researchers and clinicians participated in this Delphi panel, with a response rate of 80 %, 100 %, and 100 % across three rounds. Consensus was reached on... Read More | Comment