Key result
Step-down unit care was associated with an absolute decrease in 30-day hospital readmission of 3.9% for low-severity ICU patients, and a 2.5% absolute decrease in mortality for high-severity patients.
Why the study?
It was unclear whether and how step-down unit admission after ICU discharge affects patient outcomes.
Does admission to a step-down unit after ICU discharge improve clinical outcomes (mortality, readmissions, length of stay) in adult medical patients?
Observational (n=11,058)
Yes
Does admission to a step-down unit after ICU discharge improve clinical outcomes (mortality, readmissions, length of stay) in adult medical patients?
Absolute Risk Reduction: 3.9 (95% CI 3.6–4.1)
Absolute Event Rate: 20.2% vs 24.1%
Absolute Risk Reduction: 3.9%
p-value: p=<0.001
Step-down unit care following ICU discharge is associated with significant improvements in mortality, length of stay, and readmission rates, particularly for high-risk patients.
Supports step-down evaluation post-ICU; leaves open randomized confirmation of readmission and mortality benefits.
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Lekwijit et al. (2020) conducted an observational in Critical illness requiring ICU admission (n=11,058). Step-down unit care vs. General medical/surgical ward was evaluated on Hospital readmission within 30 days (lower illness severity patients) (ARR 3.9%, 95% CI 3.6-4.1%, p=<0.001). Step-down unit care was associated with an absolute decrease in 30-day hospital readmission of 3.9% for low-severity ICU patients, and a 2.5% absolute decrease in mortality for high-severity patients.
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