Implementation of an ICU follow-up clinic: outcomes and patient satisfaction after 1 year

Cerda, G De la

doi:10.1186/cc12476

Cited by 2 publications

(2 citation statements)

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“…This attendance rate of 60% is similar to that reported in similar civilian services. 2 Significant findings are shown in Table 2. All patients were male with a median (IQR) age of 26.5 (23-31) years.…”

Section: Resultsmentioning

confidence: 92%

Intensive Care Follow-up in UK Military Casualties: A One-Year Pilot

Scott

Davies

Dutton

et al. 2014

Journal of the Intensive Care Society

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Military casualties requiring intensive care were reviewed in a pilot follow-up clinic at approximately three to six months post discharge. All patients reviewed had suffered traumatic injuries in Afghanistan with a median New Injury Severity Score (NISS) of 41. Approximately 50% of casualties reviewed reported hallucinations while on ICU which were often intense and unpleasant. The predominant sedative agents used were morphine and midazolam. Occipital alopecia and pressure sores were reported as an unexpected finding in 35% of casualties. This appears to be permanent in 25% of cases and has required surgery in a small number of cases. Personality changes and anger are common and this cohort of patients can be sensitive to perceived stigmatising concerns regarding referral to psychiatric support services. Patient diaries, which were begun on intensive care in Afghanistan and continued through until discharge in the UK, were found to be very helpful. A significant proportion of clinic attendees thought the pilot clinic was helpful with a quarter of survey responders finding it very helpful. However, this was commonly based on the perception that they were helping the defence medical services improve delivery of care.

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Section: Resultsmentioning

confidence: 92%

Intensive Care Follow-up in UK Military Casualties: A One-Year Pilot

Scott

Davies

Dutton

et al. 2014

Journal of the Intensive Care Society

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“…Targeted interventions, such as critical care transitions programs or ICU follow-up clinics, may be of benefit by connecting these patients with family physicians, allied health professionals, and community network supports, addressing ICU complications and chronic diseases, and improving transitions in care. 32,37,38 Additionally, virtual care technologies developed during the COVID-19 pandemic may have a role to improve healthcare access, particularly for rural or remote areas. 39 Randomized trials or well-designed prospective studies evaluating accelerated discharge pathways from ICU, standardized discharge criteria, and/or targeted interventions are warranted to improve the safety of direct discharge from the ICU.…”

Section: Discussionmentioning

confidence: 99%

Long-term Safety of Directly Discharging Patients Home from the ICU Compared to Ward Transfer

Gupta

Shahab

et al. 2022

J Intensive Care Med

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Purpose: To evaluate the long-term safety of directly discharging intensive care unit (ICU) survivors to their home. Methods: A retrospective observational cohort of 341 ICU survivors who were directly discharged home from the ICU (“direct discharge”) or discharged home ≤72 hours after ICU transfer to the ward (“ward transfer”) was conducted in Regina, Saskatchewan ICUs between September 1, 2016 and September 30, 2018. The primary outcome was 90-day hospital readmission. Secondary outcomes included 30-day, 90-day, and 365-day emergency department (ED) visits, 30-day and 365-day hospital readmissions, and 365-day mortality. All outcomes were evaluated by multivariable Cox regression after adjustment for demographic and clinical characteristics. Results: Of 341 survivors (25.5% of total ICU visits), 148 (43.4%) patients were direct discharges and 193 (56.6%) were ward transfers. The median age was 46 years (interquartile range, 34-62), 38.4% were female, and 61.8% resided in Regina. Compared to the ward transfer cohort, more patients in the direct discharge cohort had at least one 90-day hospital readmission (30.4% versus 17.1% of patients, adjusted hazard ratio 2.09, 95% confidence interval 1.28-3.40, P = .003), after adjustment. Additionally, there were more 90-day ED visits ( P = .045), and 30-day ( P = .049) and 365-day hospital readmissions ( P = .03), after adjustment. Conclusions: In Saskatchewan, direct discharge compared to ward transfer was associated with an increase in 90-day hospital readmissions, and potentially other clinical outcomes. Further study is necessary.

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Implementation of an ICU follow-up clinic: outcomes and patient satisfaction after 1 year

Cited by 2 publications

References 0 publications

Intensive Care Follow-up in UK Military Casualties: A One-Year Pilot

Intensive Care Follow-up in UK Military Casualties: A One-Year Pilot

Long-term Safety of Directly Discharging Patients Home from the ICU Compared to Ward Transfer

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