Clinical trajectories of critically ill patients discharged directly from a critical unit to a postacute care facility: retrospective cohort

To describe the clinical trajectories of patients discharged directly from a critical unit to a postacute care facility. This was a retrospective cohort study of patients who were transferred from an intensive care unit or intermediate care unit to a postacute care facility between July 2017 and Apr...

Full description

Saved in:

Bibliographic Details
Published in:	Critical care science Vol. 36; p. e20240015en
Main Authors:	Ramos, João Gabriel Rosa, Souza Neto, Milton José de, Rezende, Alef Santiago, Ferreira, Flavia Dos Santos, Amorim, Yanne Danielly Santos, Souza, Flaviane Ribeiro de, Andrade, Lucas Freire de
Format:	Journal Article
Language:	English Portuguese
Published:	Brazil Associação de Medicina Intensiva Brasileira - AMIB 2024
Subjects:	Aged Aged, 80 and over Cohort Studies Critical Illness - rehabilitation Female Functional Status HEALTH CARE SCIENCES & SERVICES Humans Intensive Care Units - statistics & numerical data Length of Stay - statistics & numerical data Male MEDICINE, GENERAL & INTERNAL Middle Aged Original Palliative Care - statistics & numerical data Patient Discharge - statistics & numerical data Patient Transfer - statistics & numerical data Retrospective Studies Subacute Care Idoso Cuidados paliativos Subacute care Alta do paciente Patient discharge Hospitalização Hospitalization Delivery of health care Functional status Intensive care units Palliative care Atenção à saúde Aged Cuidados semi-intensivos Estado funcional Unidades de terapia intensiva Tempo de permanência Length of stay
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	To describe the clinical trajectories of patients discharged directly from a critical unit to a postacute care facility. This was a retrospective cohort study of patients who were transferred from an intensive care unit or intermediate care unit to a postacute care facility between July 2017 and April 2023. Functional status was measured by the Functional Independence Measure score. A total of 847 patients were included in the study, and the mean age was 71 years. A total of 692 (82%) patients were admitted for rehabilitation, while 155 (18%) were admitted for palliative care. The mean length of stay in the postacute care facility was 36 days; 389 (45.9%) patients were discharged home, 173 (20.4%) were transferred to an acute hospital, and 285 (33.6%) died during hospitalization, of whom 263 (92%) had a do-not-resuscitate order. Of the patients admitted for rehabilitation purposes, 61 (9.4%) had a worsened functional status, 179 (27.6%) had no change in functional status, and 469 (63%) had an improved functional status during hospitalization. Moreover, 234 (33.8%) patients modified their care goals to palliative care, most of whom were in the group that did not improve functional status. Patients whose functional status improved during hospitalization were younger, had fewer comorbidities, had fewer previous hospitalizations, had lower rates of enteral feeding and tracheostomy, had higher Functional Independence Measure scores at admission to the postacute care facility and were more likely to be discharged home with less complex health care assistance. Postacute care facilities may play a role in the care of patients after discharge from intensive care units, both for those receiving rehabilitation and palliative care, especially for those with more severe illnesses who may not be discharged directly home.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Conflicts of interest: None. Responsible editor: Dimitri Gusmao-Flores https://orcid.org/0000-0003-2847-8439
ISSN:	2965-2774 2965-2774
DOI:	10.62675/2965-2774.20240015-en