Key result
An intensivist-led critical care transition program resulted in a non-significant reduction in critical care department readmissions (0.8% vs 4.1%, p=0.09) compared to historic controls.
Why the study?
The study was conducted to evaluate the impact of a post-discharge critical care transition program on ICU readmission, in-hospital mortality, and six-month survival.
Does an intensivist-led critical care transition program reduce critical care department readmission and mortality in critically ill patients post-ICU discharge?
Observational (n=328)
No
Does an intensivist-led critical care transition program reduce critical care department readmission and mortality in critically ill patients post-ICU discharge?
Absolute Event Rate: 0.8% vs 4.1%
p-value: p=0.09
An intensivist-led critical care transition program significantly improved in-hospital and six-month mortality among critically ill patients discharged from the ICU.
May support intensivist-led transitions post-ICU; hypothesis-generating and requires RCT confirmation before practice change.
OBJECTIVE: Evaluate the impact of a post-discharge critical care transition program (CTP) on intensive care unit (ICU) readmission, in-hospital mortality, and six-month survival. METHODS: This was a prospective observational, single-center study, with a before-after design, in a critical care department in a tertiary hospital in Northern Portugal. Critically ill patients with ICU stay > 48 h or intermediate care stay >72 h or tracheostomized patients were included in the program. Historic controls included critically ill patients admitted in the six months prior to program implementation. The follow-up visit included a medical evaluation by an intensivist and a meeting with the attending physician. The primary outcome was critical care department readmission. Secondary outcomes were mortality at hospital discharge, 28-day, and six-month mortality. The readmission rate was compared between groups. Multivariate analysis and Kaplan-Meyer survival analysis were used to evaluate survival benefits. RESULTS: Between September 2020 and March 2021, 132 patients were included in the CTP. The Control group included 196 patients. The intensivist's assessment led to management change in 15.1% of patients. The CTP group had a non-significant lower readmission rate (0.8% vs. 4.1%; p=0.09). Multivariate analysis showed a benefit for the CTP regarding in-hospital, 28-day, and six-month mortality. Kaplan-Meyer survival analysis showed improved survival in the CTP group. CONCLUSIONS: The CTP reduced, non-significantly, the readmission rate, and significantly improved in-hospital and six-month mortality. Further analyses are needed to improve inclusion criteria and better allocate human resources.
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Neto et al. (2022) conducted an observational in Critically ill patients post-ICU discharge (n=328). Intensivist-led critical care transition program vs. Historic controls was evaluated on Critical care department readmission (p=0.09). An intensivist-led critical care transition program resulted in a non-significant reduction in critical care department readmissions (0.8% vs 4.1%, p=0.09) compared to historic controls.
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