ArticleIndian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine2018
What Happens to Patients Discharged Against Medical Advice?
Article in Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Time to diagnosis of acute kidney injury and its predictors among outborn neonates in India: a competing-risk analysis of tele-ICU network data (2022-2024).The Lancet regional health. Southeast Asia · 2026Article
- Article
- Children Discharged Against Medical Advice and Their Outcome in a Public Hospital in India: A Prospective Cohort Study.Indian pediatrics · 2025Article
- Factors affecting discharge against medical advice (DAMA) at a private level 1 trauma centre: A retrospective cohort study.The Indian journal of medical research · 2025Article
- Acute Stroke in the Emergency Department: Profiles of Patients and Obstacles to Acute Intervention.Cureus · 2024Article
- Prevalence of frailty and association with patient centered outcomes: A prospective registry-embedded cohort study from India.Journal of critical care · 2024Article
- Traumatic Brain Injury in Cameroon: A Prospective Observational Study in a Level I Trauma Centre.Medicina (Kaunas, Lithuania) · 2023Observational
- The care and transport of trauma victims by layperson emergency medical systems: a qualitative study in Delhi, India.BMJ global health · 2019Article
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Authors and funding
5 authors.
Funding
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Abstract
introductionDischarge against medical advice (DAMA) when requested by family members of patients in Indian Critical Care Units (CCUs) leads to loss of follow-up and unknown patient outcomes. Exclusion of these patients from research analysis and quality audits confounds these results. We hence explored the proportion of patients leaving DAMA, reasons, and their outcomes at 30 and 90 days.
methodsThis was a prospective study of CCU patients admitted from July 2013 to February 2014. All patients, who were DAMA during this period, were included in this study. Demographics, APACHE data, and outcomes were collected and compared to patients discharged regularly during the same period. Outcomes of DAMA patients at 30 and 90 days were gathered by telephone follow-up.
resultsAmong the 663 patients admitted to the CCU, 15.1% (100 patients) were DAMA. The baseline APACHE score of the DAMA group was higher than the regular discharge group (29.5 ± 8.6 vs. 26.1 ± 10.3;
conclusionA significant proportion of patients in the CCU get DAMA despite high severity of illness. Understanding the outcomes of these patients will help refine CCU quality audit reports and research study results.
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