Death on the General Wards after Discharge from ICU

Lee, Jong Seok; Han, Dong Woo; Shim, Yeon Hee; Nam, Sang Beom; Ahn, Jun Yong; Shin, Cheung Soo

Abstract

BACKGROUND: Intensive care units (ICUs) provide a service for patients with potentially recoverable disease who might potentially benefit from closer observation and treatment. However, a number of patients who are successfully discharged from ICU subsequently die during their hospital admission. The aim of this study was to identify the incidence and characteristics of these deaths in general wards after discharge from ICUs.
METHODS
Patients who were admitted to our ICU were classified in the following manner; Group 1, patients who survived to hospital discharge; Group 2, patients who died in the ICU; Group 3, patients who died in general wards after discharge from the ICU. Data was collected and patients age, sex, main diagnosis, Acute Physiology and Chronic Health Evaluation (APACHE) II scores on the admission, and number of days in the ICU were compared.
RESULTS
1498 consecutive patients were admitted to the general ICU, and 1339 patients were discharged alive from hospital, 114 patients died in the ICU and 45 patients died during their post ICU hospital stay. 28% of the deaths after intensive care occurred in general wards before discharge from hospital. Among those patients who died in general wards, 7 (15.5%) were expected to survive. 29 (64%) had been withdrawn from sustained therapy before discharge from the ICU.
CONCLUSIONS
Although some deaths following ICU discharge were inevitable, others were unexpected, and may have been preventable.