Key result
Post-ICCU clinic attendance linked to an absolute ~21% reduction in 30-day hospital readmissions.
Why the study?
Survivors of critical illness experience complex physical and mental health conditions known as post-intensive care syndrome, prompting the need to define the post-discharge needs of CCU survivors.
Does attendance at a dedicated post-intensive cardiac care outpatient clinic reduce early hospital readmissions and identify health care needs among coronary care unit survivors?
Cohort (n=134)
No
Does attendance at a dedicated post-intensive cardiac care outpatient clinic reduce early hospital readmissions and identify health care needs among coronary care unit survivors?
A targeted post-intensive cardiac care clinic is a feasible model that uncovers significant post-intensive care syndrome burden in CCU survivors and is associated with reduced early hospital readmissions.
Answers are grounded in this paper and cite their sources.
Supports dedicated post-CCU clinics for survivors; hypothesis-generating and requires RCTs before practice change.
Objective: Patients who survive critical illness endure complex physical and mental health conditions, referred to as post-intensive care syndrome (PICS). The University of Michigan's post-intensive cardiac care outpatient long-term outreach (PICCOLO) clinic is designed for patients recently admitted to the coronary care unit (CCU). The long-term goal of this clinic is to understand post-CCU patients' needs and design targeted interventions to reduce their morbidity and mortality post-discharge. As a first step toward this goal, we aimed to define the post-discharge needs of CCU survivors. Design setting particpants: We retrospectively reviewed case-mix data (including rates of depression, PTSD, disability, and cognitive abnormalities) and health outcomes for patients referred to the PICCOLO clinic from July 1, 2018, through June 30, 2021 at Michigan Medicine. Results: 26, 38.8 %). Further, patients also reported high rates of physical difficulty (mean WHODAS 2.0 score 28.4 %, consistent with moderate physical difficulty). Consistent with medical intensive care unit (ICU) patients, CCU survivors experience PICS. Conclusion: This work highlights the feasibility of an outpatient care model and the need to leverage information gathered from this care model to develop treatment strategies and pathways to address symptoms of PICS in CCU survivors, including depression, cognitive impairment, and physical disability.
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Mason et al. (2024) conducted a cohort in Coronary care unit (CCU) survivors / Post-intensive care syndrome (n=134). PICCOLO clinic attendance vs. Referred but not seen in clinic within 30 days was evaluated on 30-day hospital readmissions (p=0.008). Attendance at the post-intensive cardiac care outpatient clinic was associated with a lower rate of 30-day hospital readmissions compared to non-attendance.
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