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837: RANDOMIZED TRIAL OF AN INTENSIVE CARE UNIT RECOVERY PROGRAM FOR SURVIVORS OF CRITICAL ILLNESS

Learning Objectives: Whether a structured ICU recovery program with a multidisciplinary team of critical care physicians, nurse practitioners, pharmacists, psychologists, and case managers could improve outcomes spanning the inpatient and outpatient settings could improve post-ICU care and patient outcomes remains unknown. A prospective, single-center, randomized trial comparing usual care for survivors of critical illness to a multidisciplinary ICU recovery program with structured inpatient and outpatient interventions was conducte. Our primary hypothesis was that an ICU recovery program would increase the number of ICU recovery program intervention components received. Our secondary hypothesis was that an ICU recovery program would decrease the incidence of 30-day same-hospital readmission. Methods: Adult patients admitted to the medical ICU for at least 48 hours with a predicted risk of 30-day readmission risk of at least 15% were included. Patients randomized to the ICU recovery program group received a structured 10-component intervention, including an inpatient visit by a nurse practitioner, an informational pamphlet, a 24-hour a day phone number for the recovery team, and an outpatient ICU recovery clinic visit with a critical care physician, nurse practitioner, pharmacist, psychologist, and case manager. For patients randomized to the usual care group, all aspects of care were determined by treating clinicians. Results: Patients randomized to the ICU recovery program (n=111) and usual care (n=121) were similar at baseline. Patients in the ICU recovery program group received more components of the ICU recovery program intervention than patients in the usual care group. A total of 100 patients (90.1%) in the ICU recovery program group received at least one of the inpatient components of the ICU recovery program, whereas only 14 patients (12.6%) in the ICU recovery program group received any outpatient component of the ICU recovery program. The median number of days from hospital discharge until readmission was 31 [22–44] days in the ICU recovery program group and 23 [6–37] days in the usual care group (P = 0.04). Conclusions: This randomized trial found that a multi-disciplinary ICU recovery program could effectively deliver inpatient interventions to survivors of critical illness. Outpatient aspects of the intervention were infrequently delivered. The ICU recovery program appeared to result in greater readmission-free survival compared with usual care