Delayed Discharge From the Intensive Care Unit Is Associated With Longer Hospital Lengths of Stay.

OBJECTIVE: The study authors sought to determine if delayed discharge from the intensive care unit (ICU) secondary to a lack of floor beds led to longer postoperative hospital length of stay (LOS) or more hospital readmissions. DESIGN: A retrospective study comparing patients with delayed discharge from the ICU to patients without delayed discharge. SETTING: At a cardiovascular ICU in a tertiary care university hospital. PARTICIPANTS: A total of 5,777 patients that were ready for discharge from the ICU after recovering from cardiac surgery. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The authors used linear regression to measure postoperative hospital LOS and logistic regression to measure hospital readmission in patients whose transfer out of the ICU was delayed at least overnight to patients who were transferred out the same day. There were 3,903 patients transferred to the stepdown unit on the same day as the transfer order and 1,874 patients were transferred on a subsequent day. The postoperative LOS was shorter in the no delay group (9 ± 9 v 11 ± 10 days, standardized difference = 0.162), whereas the stepdown unit stay was similar (6 ± 6 v 5 ± 6 days, standardized difference = 0.076). The readmission rates were 15% in the no delay group versus 14% in the delayed discharge group (standardized difference = 0.032). After adjustment, the authors found by linear regression that delayed discharge was associated with an increase (0.72 [95% CI 0.43-1.01] days, p < 0.001) in postoperative LOS but was not associated with readmission. CONCLUSIONS: The study authors found that patients who had their discharge from the ICU delayed had an increased hospital LOS but a similar rate of hospital readmission.