Department of Anaesthesia and Intensive Care, Royal Victoria Infirmary and the University Department of Surgical and Reproductive Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne NE1 4LP, UK.
OBJECTIVE: To examine the effect of high levels of pre-intensive care unit (ICU) discharge care, as assessed by the Therapeutic Intervention Scoring System (TISS), on subsequent hospital mortality. DESIGN: A 1-year prospective, observational study. SETTING: The ICU and wards of a university teaching hospital with no high dependency facility (HDU). PATIENTS: A total of 283 patients were discharged to hospital wards between July 1997 and June 1998. ++RESULTS: 11 % of all ICU discharges subsequently died in hospital. Patients discharged with a TISS of 20 or greater had a 21.4 % mortality compared to 3.7 % for those with a TISS of less than 10. Increasing age, Acute Physiology Score (APS) on admission and male sex were also significantly associated with post-discharge death. CONCLUSIONS: In a hospital without HDU facilities, patients who are receiving HDU levels of care on discharge from the ICU have a high in-hospital mortality.