title: [Impact of the premature discharge on hospital mortality after a stay in an intensive care unit].
abstract: OBJECTIVE
  To determine the frequency and to evaluate the relationship between premature discharge and post-ICU hospital mortality.
  
  
  METHODS
  A prospective registry was made for patients admitted during six consecutive years, performing a retrospective analysis of the data on the first admission of ICU survivors.
  
  
  METHODS
  A 10-bed general ICU in a 540-bed tertiary-care community hospital.
  
  
  METHODS
  1,521 patients with an ICU stay longer than 12 hours, discharged alive to wards with known hospital outcome.
  
  
  METHODS
  None.
  
  
  METHODS
  We recorded the patient data, including types of ICU discharge, normal or premature, and studying their relationship with post-ICU hospital mortality. The types of ICU discharge were also evaluated versus ICU readmission rate and post-ICU length of stay.
  
  
  RESULTS
  There were 165 patients (10.8%) with premature discharge. Mortality rate was 11.6% (176 patients). The factors related with mortality were withdrawal and limitation of life-sustaining treatments (OR=14.02 [4.6-42.6]), readmissions to ICU (OR=3.46 [1.76-6.78]), premature discharge (OR=2.6 [1.06-4.41]), higher organ failure score on discharge from the ICU (OR=1.16 [1.01-1.32]) and age (OR=1.03 [1.01-1.05]). Readmission rates and post-ICU length of stay were similar among patients with premature and normal discharge (7.3% vs. 8.2%, P=.68 and 16.7±16.7 days vs. 18.7±21.3 days, respectively, P=.162).
  
  
  CONCLUSIONS
  Premature discharges appear to be common in our setting and have a significant impact on mortality. Types of ICU discharge do not seem to be related with other outcome variables in the hospital care of critically ill patients.
authors.affiliation: Unidad de Cuidados Intensivos Polivalente, Hospital Juan Ramón Jiménez, Huelva, España. mjrcarvajal@gmail.com
authors.forename: M
authors.initials: M
authors.lastname: Rodríguez-Carvajal
authors.forename: D
authors.initials: D
authors.lastname: Mora
authors.forename: A
authors.initials: A
authors.lastname: Doblas
authors.forename: M
authors.initials: M
authors.lastname: García
authors.forename: P
authors.initials: P
authors.lastname: Domínguez
authors.forename: A
authors.initials: A
authors.lastname: Tristancho
authors.forename: M
authors.initials: M
authors.lastname: Herrera
mesh_terms: D000328:Adult; D000368:Aged; D001509:Bed Occupancy; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D006297:Health Services Accessibility; D006746:Hospital Bed Capacity, 500 and over; D017052:Hospital Mortality; D006769:Hospitals, General / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data* / Q000600:supply & distribution; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D018447:Medical Futility; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D010360:Patient Transfer / Q000706:statistics & numerical data; D016079:Refusal to Treat; D012042:Registries; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology