An audit of deaths occurring in hospital after discharge from the intensive care unit

Abstract

The aim of the study was to conduct an audit of patients who died in the ward after discharge from the intensive care unit (ICU). Clinical records of those who died in the ward following discharge between 1991 and 1997 were reviewed. Patients were retrospectively grouped according to whether death was expected, unexpected or likely to die within one year. The causes of death, times in ICU and hospital, demographics, and APACHE II scores were compared. Ninety-nine patients were studied, of whom 60 were triaged to the ward expected to die at the time of ICU discharge. Five of the patients were classified as not expected to die. Of the remaining 34 patients, 65% were debilitated with more than one organ disease and 62% eventually had some treatment withdrawn on the ward. After discharge from ICU, no obvious ward treatment deficiencies were found to contribute to death. However, of those who were admitted to the ICU from the ward and who later died when back in the ward, there seemed to be avoidable events pre-ICU admission in eight (36%) patients, some of which may have contributed to the later death of the patient.