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Impact of Intensive Care Unit Discharge Delay on Liver Transplantation Outcomes

Background: For general intensive care unit (ICU) patients, ICU discharge delay (ICUDD) has been associated with an increased hospital length of stay (LOS) and the acquisition of multi-resistant organism (MRO) infections. The impact of ICUDD on liver transplant (LT) recipients is unknown. Methods: W...

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Autores principales: Salimi, Shirin, Pandya, Keval, Davis, Rebecca Jane, Crawford, Michael, Pulitano, Carlo, Strasser, Simone Irene, McCaughan, Geoffrey William, Majumdar, Avik, Liu, Ken
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9101850/
https://www.ncbi.nlm.nih.gov/pubmed/35566687
http://dx.doi.org/10.3390/jcm11092561
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author Salimi, Shirin
Pandya, Keval
Davis, Rebecca Jane
Crawford, Michael
Pulitano, Carlo
Strasser, Simone Irene
McCaughan, Geoffrey William
Majumdar, Avik
Liu, Ken
author_facet Salimi, Shirin
Pandya, Keval
Davis, Rebecca Jane
Crawford, Michael
Pulitano, Carlo
Strasser, Simone Irene
McCaughan, Geoffrey William
Majumdar, Avik
Liu, Ken
author_sort Salimi, Shirin
collection PubMed
description Background: For general intensive care unit (ICU) patients, ICU discharge delay (ICUDD) has been associated with an increased hospital length of stay (LOS) and the acquisition of multi-resistant organism (MRO) infections. The impact of ICUDD on liver transplant (LT) recipients is unknown. Methods: We retrospectively studied consecutive adult LT between 2011 and 2019. ICUDD was defined as >8 h between a patient being cleared for discharge to ward and the patient leaving the ICU. Results: 550 patients received LT and the majority (68.5%) experienced ICUDD. The median time between clearance for ward and the patient leaving the ICU was 25.6 h. No donor or recipient variables were associated with ICUDD. Patients cleared for discharge early in the week (Sunday-Tuesday) and those discharged outside routine work hours were more likely to experience ICUDD (p = 0.001 and p < 0.001, respectively). The median hospital LOS was identical (18 days, p = 0.96) and there were no differences in other patient outcomes. Patients who became colonized with MRO in the ICU spent a longer time there compared to those who remained MRO-free (9 vs. 6 days, p < 0.001); however, this was not due to ICUDD. Conclusion: ICUDD post-LT is common and does not prolong hospital LOS. ICUDD is not associated with adverse patient outcomes or MRO colonization.
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spelling pubmed-91018502022-05-14 Impact of Intensive Care Unit Discharge Delay on Liver Transplantation Outcomes Salimi, Shirin Pandya, Keval Davis, Rebecca Jane Crawford, Michael Pulitano, Carlo Strasser, Simone Irene McCaughan, Geoffrey William Majumdar, Avik Liu, Ken J Clin Med Article Background: For general intensive care unit (ICU) patients, ICU discharge delay (ICUDD) has been associated with an increased hospital length of stay (LOS) and the acquisition of multi-resistant organism (MRO) infections. The impact of ICUDD on liver transplant (LT) recipients is unknown. Methods: We retrospectively studied consecutive adult LT between 2011 and 2019. ICUDD was defined as >8 h between a patient being cleared for discharge to ward and the patient leaving the ICU. Results: 550 patients received LT and the majority (68.5%) experienced ICUDD. The median time between clearance for ward and the patient leaving the ICU was 25.6 h. No donor or recipient variables were associated with ICUDD. Patients cleared for discharge early in the week (Sunday-Tuesday) and those discharged outside routine work hours were more likely to experience ICUDD (p = 0.001 and p < 0.001, respectively). The median hospital LOS was identical (18 days, p = 0.96) and there were no differences in other patient outcomes. Patients who became colonized with MRO in the ICU spent a longer time there compared to those who remained MRO-free (9 vs. 6 days, p < 0.001); however, this was not due to ICUDD. Conclusion: ICUDD post-LT is common and does not prolong hospital LOS. ICUDD is not associated with adverse patient outcomes or MRO colonization. MDPI 2022-05-02 /pmc/articles/PMC9101850/ /pubmed/35566687 http://dx.doi.org/10.3390/jcm11092561 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Salimi, Shirin
Pandya, Keval
Davis, Rebecca Jane
Crawford, Michael
Pulitano, Carlo
Strasser, Simone Irene
McCaughan, Geoffrey William
Majumdar, Avik
Liu, Ken
Impact of Intensive Care Unit Discharge Delay on Liver Transplantation Outcomes
title Impact of Intensive Care Unit Discharge Delay on Liver Transplantation Outcomes
title_full Impact of Intensive Care Unit Discharge Delay on Liver Transplantation Outcomes
title_fullStr Impact of Intensive Care Unit Discharge Delay on Liver Transplantation Outcomes
title_full_unstemmed Impact of Intensive Care Unit Discharge Delay on Liver Transplantation Outcomes
title_short Impact of Intensive Care Unit Discharge Delay on Liver Transplantation Outcomes
title_sort impact of intensive care unit discharge delay on liver transplantation outcomes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9101850/
https://www.ncbi.nlm.nih.gov/pubmed/35566687
http://dx.doi.org/10.3390/jcm11092561
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