Discharging patients home from the intensive care unit: A new trend

Table 1 Patient characteristics

Ref.	Sample size (n)	Age	Sex (%)	Race/ethnicity	Comorbidities (%)	Admitting/discharge diagnoses	Morbidity index	LOS (days)	Location before ICU (%)
Studies looking at adult population
Martin et al[7]	197089	80-105 vs 18-39 (OR: 0.36; 95%CI: 0.34-0.39)	Male > female (OR > 1)	-	Chronic dialysis (OR > 1), diabetes (OR > 1)	Day procedure (OR: 2.82; 95%CI: 2.46-3.23), seizure, overdose or poisoning (OR: 1.35; 95%CI: 1.23-1.47), diabetic ketoacidosis or diabetic complications (OR: 1.35; 95%CI: 1.2-1.51), GI bleed (OR > 1)	Charlson comorbidity index of 0 and 1 (OR: 1.74; 95%CI: 1.63-1.85)	-	Day procedure (OR: 2.82; 95%CI: 2.46-3.23), clinic (OR > 1), prior ICU admission (OR > 1), prior hospitalization (OR > 1)
Lau et al[2]	137	44.5 ± 16.7 (P = 0.004)	Female 46 (33.6) (P = 0.13)	-	(P < 0.0001) hypertension (27), GERD (17.5), depression (16.1), diabetes (10.2), substance abuse/overdose (14.6)	Number of discharge diagnoses (P = 0.002) overdose, subglottic stenosis/angioedema/laryngospasm, trauma, pulmonary embolism, and seizure	Charlson comorbidity index score: 1.65 ± 2.1 (P = 0.01), NMES (at admission) 26.6 ± 7.2, NMES (at discharge/transfer) 16.85 ± 8.3 (P = 0.02)	2.7 ± 3.7 (P = 0.001)	Emergency department 188 (56.8), another hospital 78 (23.7), home (direct ICU admission) 17 (7.5), floor 25 (7.6), OR/PACU 9 (2.7), other/unknown 14 (4.2)
Patel et al[8]	331	54.1 ± 17.25	158 (47.7)	White (46.2), Black (41.7), Asian/pacific-islander (3.6), Hispanic/Latino (5.1), other/unknown (3.3)	-	Monitoring (n = 13), sepsis/septic shock (n = 25), diabetic ketoacidosis (n = 13), electrolyte abnormalities due to alcohol abuse (n = 7), hyperkalemia (n = 5), hemodynamic instability (n =11), arrhythmia (n = 10), hypertensive urgency or emergency (n = 5), systolic and diastolic heart failure exacerbation (n = 5), angioedema (n = 29), medication desensitization (n = 19), pneumonia (n = 28), pulmonary embolism (n = 25), COPD exacerbation (n = 21), acute respiratory disease syndrome (n = 20), asthma exacerbation (n = 10), gastrointestinal hemorrhage (n = 34), hepatic failure (n = 9)	MPM0-III predicted mortality % 15.9 ± 11.1, NEMS on admission 19.45 ± 8.58	2.41 (P = 0.001)	-
Stelfox et al[3]	6732	47 (P < 0.001)	Female 393 (P = 0.67)	-	Diabetes 143 (P < 0.001), chronic lung disease 151 (P = 0.11), chronic kidney disease 23 (P < 0.001), liver disease 37 (P < 0.001), cancer 31 (P < 0.001), chronic heart or peripheral vascular disease 72 (P < 0.001), neurological disease 17 (P < 0.001), any comorbidity 360 (P < 0.001)	Admitting diagnosis (P < 0.001): Overdose, withdrawal, seizures, or metabolic coma 295, pneumonia 104, respiratory other 133, medical or neurological additional 107, trauma or orthopedic 79, cardiovascular 67, sepsis (non-pulmonary) 52, gastrointestinal 45, pregnancy or genitourinary 21, cancer 8	Charlson Score 0-1 (P < 0.001), APACHE II score, 15 (P < 0.001)	2.9 (P < 0.001)	Location before ICU (P < 0.001): Emergency department 607, ward 160, operating or recovery room 98, other Hospital 55
Basmaji et al[16]	-	-	-	-	-	-	-	-	-
Chawla et al[10]	95	61.1	Male (60)	-	-	Respiratory failure, sepsis, cardiac syndromes, gastrointestinal bleeding	MPM0II Score 31.4	4.5	-
Lau et al[6]	642	49	Male (54.9)	-	-	Overdose, pneumonia, seizures, diabetic ketoacidosis	Multiple organ dysfunction scores 7	3	-
Lam et al[22]	137	45.75	Male (66.4)	-	-	Overdose, upper airway compromise, trauma, pulmonary embolism, seizures	Multiple organ dysfunction scores 7	1.8	-
Martin et al[12]	46859	60.79 ± 17.42	Male (59)	-	COPD, diabetes, congestive heart failure, seizure, overdose	Overdose/poisoning, pneumonia (respiratory tract infection or empyema, sepsis-other, seizure/convulsions, diabetic ketoacidosis or complications of diabetes	-	0	-
Studies looking at pediatric population
Pizzuto et al[14]	532	2	Female (44)	White or Caucasian (45), black or African American (27), American Indian or Alaska Native (3), Asian (2), other (19), unknown (4)	-	Respiratory failure; insufficiency; arrest (9), diabetic ketoacidosis (6), asthma (5), acute bronchiolitis (3), sleep apnea (3), pneumonia (3), acute tracheitis (3), septicemia (3), complication of device; implant or graft (3), anomalies of cerebrovascular system, congenital (2)	-	2.1	-
Gal et al[18]	308	4.6	Female (39)	-	Atrial or ventricular septal defects, valve replacement, or conduit replacement	Cardiac procedure [191 (i.e. Catheterization)], cardiac surgery [70 (i.e. implantable)], medical condition [53 (i.e. Arrhythmia or infection)]	STAT Score 2	1	Emergency department (177), Operating room (45), post anesthesia (39), home (9), floor (8), clinic (5)
Kennedy et al[17]	702	2	Male (64.4)	-	-	Bronchiolitis, seizures, asthma, lower respiratory tract infection	-	Approximately 2	Emergency department directly admitted
Roumeliotis et al[19]	594	3	61.6	-	-	Acute intoxication, postoperative ear-nose-throat care, shock	95% of the cohort had PELOD 2 score of 0-8 (P < 0.001)	83% of patients had LOS 1-6 days. 17% had LOS > 7 days	-

LOS: Length of stay; ICU: Intensive care unit; OR: Odds ratio; CI: Confidence interval; GI: Gastrointestinal; GERD: Gastroesophageal reflux disease; NMES: Neuromuscular electrical stimulation; PACU: Post-acute care unit; MPM0-III: Mortality probability admission model-III; COPD: Chronic obstructive pulmonary disease; STAT Score: The society of thoracic surgeons-European association of cardio-thoracic surgery; PELOD 2: Pediatric logistic organ dysfunction 2; APACHE II: Acute physiology and chronic health evaluation II.