Impact of intensive care unit discharge delay after medical clearance on outcomes after liver transplantation

Autor: Rebecca J Davis, Geoffrey W. McCaughan, Keval Pandya, Avik Majumdar, Simone I. Strasser, Shirin Salimi, Michael Crawford, Carlo Pulitano, Ken Liu
Rok vydání: 2021
Předmět:
Popis: Background For general intensive care unit (ICU) patients, ICU discharge delay (ICUDD) has been shown to be associated with increased hospital length of stay (LOS) and acquiring multi-resistant organism (MRO) infections. The impact of ICUDD in liver transplant (LT) recipients is unknown. Methods We retrospectively studied consecutive adults who underwent deceased-donor LT between 2011–2019. All patients went to ICU post-operatively then to a specific transplant ward. ICUDD was defined as > 8 hours between a patient being cleared by staff for discharge to ward and the patient leaving ICU. Results 550 received LT and survived to ward discharge. Median time between clearance for ward and the patient leaving ICU was 25.6 hours (interquartile range 6.6–38.6). The majority (68.4%) of patients experienced ICUDD. No donor or recipient variables were associated with ICUDD. However, patients cleared for discharge early in the week (Sunday-Tuesday) were more likely to experience ICUDD than those cleared on Wednesday-Saturday: 77.5% vs. 62.2% (P = 0.001), while patients cleared outside routine work hours were more likely to experience ICUDD than those cleared within working hours (93.6% vs. 66.2%, P P = 0.96) and there were no differences in other patient outcomes. Patients who became colonized with MRO in ICU spent longer time there compared to those who remained MRO-free (9 vs. 6 days, P
Databáze: OpenAIRE