Prospective cohort study to estimate the safety of direct discharge to home from the intensive care unit.

CONTEXT: Traditionally, intensive care unit (ICU) discharge has followed a tiered approach of managing cases, i.e., patients are transferred to a general or parent surgical ward or high-dependency unit before being discharged to home. This practice assumes that some additional time is mandatory to observe patients who are recovering from the illness. With latest improvisations in postdischarge services for direct discharge to home (DDH), the balance is shifting in favor of DDH. AIMS: To compare the clinical outcomes and safety of ICU patients discharged directly to home with those transferred to hospital wards before being discharged. SETTINGS AND DESIGN: Prospective cohort study done at a tertiary care hospital. METHODS: According to patient's discharge or transfer to ward (TTW), they were grouped in either of the two: Group D: Direct discharge to home (DDH), Group W: TTW (minimum stay in ward 24 h). All patients were followed up to 3 months of discharge/transfer. STATISTICAL ANALYSIS USED: Continuous data of two independent groups were compared by independent Student's t-test, whereas categorical data by Chi-square (χ2) test were used. A two-tailed (α =2) P < 0.05 was considered statistically significant. RESULTS: The results showed that ICU patient discharged directly to home had better post-ICU recovery for 90 days' follow-up. CONCLUSIONS: ICU patients discharged directly to home have significantly better clinical outcomes and safety, when applied to carefully selected ICU patients compared to those transferred to hospital wards before being discharged.