ArticleCritical care (London, England)2021
Problems in care and avoidability of death after discharge from intensive care: a multi-centre retrospective case record review study.
Article in Critical care (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Exploring How Gerontological Nursing Telephone Support Can Assist Informal Caregivers of Older Adults at Hospital Discharge-A Qualitative Study.Journal of clinical nursing · 2026Article
- Physiotherapy and optimised enteral nutrition in the post-acute phase of critical illness (PHOENIX): a randomised controlled feasibility trial.EClinicalMedicine · 2026Article
- Article
- Opportunities to Improve Nutrition for Patients in Hospital After Discharge From an Intensive Care Unit: A Human Factors Analysis.Nursing in critical care · 2026Article
- Non-pharmacological post-intensive care interventions to improve patient outcome following critical illness: a scoping review.Critical care (London, England) · 2025Review
- A retrospective records review comparing the care of patients who either avoided or were admitted to an ICU following a ward-based deterioration event.Intensive & critical care nursing · 2025Article
- Article
- Transition experiences of patients and families upon discharge from intensive care: a scoping review.Revista latino-americana de enfermagem · 2025Article
- Critical Care Challenges and Mortality Predictors in Older Adults: A Comprehensive Cohort Analysis.Cureus · 2024Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundOver 138,000 patients are discharged to hospital wards from intensive care units (ICUs) in England, Wales and Northern Ireland annually. More than 8000 die before leaving hospital. In hospital-wide populations, 6.7-18% of deaths have some degree of avoidability. For patients discharged from ICU, neither the proportion of avoidable deaths nor the reasons underlying avoidability have been determined. We undertook a retrospective case record review within the REFLECT study, examining how post-ICU ward care might be improved.
methodsA multi-centre retrospective case record review of 300 consecutive post-ICU in-hospital deaths, between January 2015 and March 2018, in 3 English hospitals. Trained multi-professional researchers assessed the degree to which each death was avoidable and determined care problems using the established Structured Judgement Review method.
resultsAgreement between reviewers was good (weighted Kappa 0.77, 95% CI 0.64-0.88). Discharge from an ICU for end-of-life care occurred in 50/300 patients. Of the remaining 250 patients, death was probably avoidable in 20 (8%, 95% CI 5.0-12.1) and had some degree of avoidability in 65 (26%, 95% CI 20.7-31.9). Common problems included out-of-hours discharge from ICU (168/250, 67.2%), suboptimal rehabilitation (167/241, 69.3%), absent nutritional planning (76/185, 41.1%) and incomplete sepsis management (50/150, 33.3%).
conclusionsThe proportion of deaths in hospital with some degree of avoidability is higher in patients discharged from an ICU than reported in hospital-wide populations. Extrapolating our findings suggests around 550 probably avoidable deaths occur annually in hospital following ICU discharge in England, Wales and Northern Ireland. This avoidability occurs in an elderly frail population with complex needs that current strategies struggle to meet. Problems in post-ICU care are rectifiable but multi-disciplinary.
trial registrationISRCTN14658054.
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