ICU Strain Leads to Earlier Patient Discharge

(HealthDay News) — When intensive care units (ICUs) are capacity strained, patients are discharged more quickly and have slightly greater odds of being readmitted, but short-term patient outcomes are unaffected, according to a study published in the Oct. 1 issue of the Annals of Internal Medicine.

Jason Wagner, M.D., from the University of Pennsylvania in Philadelphia, and colleagues retrospectively analyzed data from 200,730 adults discharged from ICUs to hospital floors in 155 ICUs in the United States from 2001 to 2008. ICU capacity strain was based on ICU census, new admissions, and average acuity.

The researchers found that increases in the three strain variables on the days of ICU discharge were significantly associated with shorter preceding ICU length of stay and increased odds of ICU readmissions. A 6.3-hour reduction in ICU length of stay and a 1.0 percent increase in the odds of ICU readmission were seen when going from the fifth to 95th percentile of strain. There were no associations between strain variables and increased odds of subsequent death, reduced odds of being discharged home from the hospital, or longer total hospital length of stay.

“These results suggest that bed availability pressures may encourage physicians to discharge patients from the ICU more efficiently and that ICU readmissions are unlikely to be causally related to patient outcomes,” the authors write.

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