• L Smith, C M Orts, I O'Neil, A M Batchelor, A D Gascoigne, and S V Baudouin.
• 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.
• Intensive Care Med. 1999 Oct 1;25(10):1061-5.

ObjectiveTo 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.DesignA 1-year prospective, observational study.SettingThe ICU and wards of a university teaching hospital with no high dependency facility (HDU).PatientsA total of 283 patients were discharged to hospital wards between July 1997 and June 1998. ++Results11 % 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.ConclusionsIn a hospital without HDU facilities, patients who are receiving HDU levels of care on discharge from the ICU have a high in-hospital mortality.

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