ICU sedation, delirium & recovery
Safety Outcomes of Direct Discharge Home From ICUs: An Updated Systematic Review and Meta-Analysis (Direct From ICU Sent Home Study)*
Authors' conclusion
Very low-to-low certainty evidence from observational studies suggests that DDH from ICU may have no difference in safety outcomes compared with ward transfer of selected ICU patients.
Study context
- Population
- ICU patients discharged directly home or transferred to the ward3 studies pooled (6 included)
- Participants
- 49,376 patients
- Comparison
- Direct discharge home from ICU vs ward transfer
- Outcome
- Safety outcomes: readmissions, emergency department (ED) visits and mortality
Methodological detailsrandom-effects, propensity-matched cohorts, GRADE certainty assessment
- Random-effects
- Propensity-matched cohorts
- GRADE certainty assessment
Further pooled results
| Outcome | DDH | Ward transfer | RR (95% CI) | P value | |
|---|---|---|---|---|---|
| ED visits · 30-dayLow certainty · propensity-matched cohorts | 22.4% | 22.7% | 0.99 (0.95–1.02) | P = 0.39 | |
| Hospital readmissions · 30-dayVery low-to-low certainty · propensity-matched cohorts | 9.8% | 9.6% | 1.02 (0.91–1.15) | P = 0.71 | |
| Mortality · 90-dayVery low-to-low certainty · propensity-matched cohorts | 2.8% | 2.6% | 1.06 (0.95–1.18) | P = 0.29 | |
| 0.512Relative risk (log scale) |
Unmatched cohorts and subgroup analyses
- No important differences in the unmatched cohorts or across subgroup analyses
Original publication
Safety Outcomes of Direct Discharge Home From ICUs: An Updated Systematic Review and Meta-Analysis (Direct From ICU Sent Home Study)*. Crit Care Med. Published 9 November 2022. doi:10.
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