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November 9, 2022Critical Care MedicineOpen Access

Safety Outcomes of Direct Discharge Home From ICUs: An Updated Systematic Review and Meta-Analysis (Direct From ICU Sent Home Study)*

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Why the study?

The impact of direct discharge home from ICUs compared with ward transfer on safety outcomes including readmissions, emergency department visits, and mortality needed evaluation.

Does direct discharge home from ICU reduce readmissions, ED visits, and mortality compared with ward transfer in ICU patients?

Comparison

Direct discharge home from ICU vs ward transfer

Design

Systematic review and random-effects meta-analysis

Authors

VLVincent LauRDRyan F. DonnellySPSehar Parvez

Discussion

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Member takes

Overview

Supports DDH from ICU in selected patients without added safety risks; leaves open need for RCTs to confirm.

Structured PICO

Does direct discharge home from ICU reduce readmissions, ED visits, and mortality compared with ward transfer in ICU patients?

P
Population
49,376 ICU patients from 3 high-quality propensity-matched cohort studies (out of 6 total included studies)
I
Intervention
Direct discharge home (DDH) from ICU
C
Comparator
Ward transfer
O
Outcome
Safety outcomes including 30-day emergency department (ED) visits, 30-day hospital readmissions, and 90-day mortalitysafety

Direct discharge home from the ICU is associated with similar rates of ED visits, readmissions, and mortality compared to standard ward transfer in selected patients.

Limitations

  • Very low-to-low certainty evidence
  • Observational studies only

Cite This Study

Lau et al. (2022) studied this question.

synapsesocial.com/papers/6a87c33bf8efd6d7e4fb0fbahttps://doi.org/10.1097/ccm.0000000000005720
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