Concern over intensive care patients released prematurely

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Pressure on intensive care beds is causing patients to be discharged prematurely and possibly dying as a result, researchers said today.

Pressure on intensive care beds is causing patients to be discharged prematurely and possibly dying as a result, researchers said today.

A study disclosed that discharge from UK intensive care units overnight or in the early hours of the morning had doubled in the last 10 years.

Patients discharged at night had lower survival rates and were more likely to be released prematurely than those discharged during the day.

The investigators from the Intensive Care and National Audit and Research Centre in London said the trend reflected increasing demand on intensive care beds.

Kathy Rowan, one of the researchers who reported their findings in the Lancet medical journal, said: "Night discharges from ICUs are increasing in the UK.

"This trend is of concern because patients discharged at night fare significantly worse than those discharged during the day.

"Night discharges are more likely to be 'premature' in the view of the clinicians involved. The implication of these results is that many hospitals do not have enough intensive care beds."

The researchers compared the rate of discharge at night for 21,295 adult ICU admissions in 1995-98 with 10,806 admissions during the period 1988-90.

"Night" was defined as being "out of office hours" between 10pm and 6.59am and "early hours of the morning" between midnight and 4.59am.

Overall survival rates were similar in the two periods. However the proportion of night discharges had doubled in the 1995-98 period.

Patients discharged at night during the later period were more likely to leave hospital prematurely and less likely to survive than those released in the daytime.

The increased pressure on ICUs was blamed on an increase in the number of patients qualifying for intensive care treatment.

This was partly the result of the rising rate of surgical procedures such as coronary artery bypasses.

Other factors involved included poorer standards of care at night both during transfer and at the destination.

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