{
  "abstract": "Objective: To describe the components of institution-free days (IFD) after intensive care unit (ICU) admission and assess the distribution of IFD at 365 d across various admission categories.\n\nDesign: Multicentre, retrospective cohort study.\n\nSetting: Adult patients (aged ≥18 y) admitted to 12 ICUs in Queensland from 2017 to 2020.\n\nMain outcome measures: IFD is the primary composite outcome defined as the number of days alive and free of healthcare institution exposure. IFD is calculated by subtracting total number of days with healthcare institution exposure from 365. Distribution of IFD and its components were evaluated across four prespecified subgroups-diagnostic category, comorbidity groups, age quartiles, and remoteness of area of residence.\n\nResults: 44 541 ICU admissions were analysed, of which 19 706 (44.2%), 17 488 (39.2%), and 7347 (16.5%) were medical, elective, and nonelective surgical admissions, respectively. The median IFD was higher for elective surgical patients as compared to nonelective surgical and medical admissions (348 d [interquartile range (IQR): 330–355] vs. 330 [IQR: 267–349] d vs. 325 [IQR: 185–349]). Hospital readmission days were the major contributor to IFD, with 60.4% of all survivors experiencing at least one hospital readmission day within 365 d. The mean hospital readmission days were highest for nonelective surgical admissions as compared to elective and medical admissions (18.5 [standard deviation (SD):18.4] vs. 13.9 [SD: 15.9] vs. 16.1 [SD: 19.2] days).\n\nConclusion: Hospital readmission days were the predominant contributor to institution-days and principal driver of lower IFD for ICU survivors. Medical ICU admissions had the least IFD, followed by nonelective surgical and elective surgical patients.",
  "abstract_shown": true,
  "affiliations": [
    "Intensive Care Unit, Caboolture Hospital, Caboolture, QLD, Australia",
    "Institute for Intelligent Systems Research and Innovation, Deakin University, 75 Pigdons Rd, Waurn Ponds, VIC, 3216, Australia",
    "School of Medicine, Queensland University of Technology, Brisbane, QLD, Australia",
    "School of Midwifery and Nursing, Queensland University of Technology, Brisbane, QLD, Australia",
    "Intensive Care Unit, Gold Coast Health, Southport, QLD, Australia",
    "Intensive Care Unit, Townsville University Hospital, Douglas, QLD, Australia",
    "Intensive Care Unit, Cairns Hospital, Cairns, QLD, Australia",
    "Intensive Care Unit, Logan Hospital, Metro South Hospital and Health Service, Brisbane, Australia",
    "Intensive Care Unit, Mackay Hospital, Mackay, QLD, Australia",
    "Intensive Care Unit, Rockhampton Hospital, QLD, Australia",
    "Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 15,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Prashanti Marella"
    },
    {
      "affs": [
        1
      ],
      "name": "Roohallah Alizadehsani"
    },
    {
      "affs": [
        2
      ],
      "name": "Kevin B. Laupland"
    },
    {
      "affs": [
        3
      ],
      "name": "Samantha Keogh"
    },
    {
      "affs": [
        2
      ],
      "name": "Felicity Edwards"
    },
    {
      "affs": [
        2
      ],
      "name": "Kyle White"
    },
    {
      "affs": [
        4
      ],
      "name": "Kerina Denny"
    },
    {
      "affs": [
        5
      ],
      "name": "Stephen Whebell"
    },
    {
      "affs": [
        6
      ],
      "name": "Sebastiaan Blank"
    },
    {
      "affs": [
        7
      ],
      "name": "Aashish Kumar"
    },
    {
      "affs": [
        8
      ],
      "name": "Stephen Luke"
    },
    {
      "affs": [
        9
      ],
      "name": "Antony Attokaran"
    },
    {
      "affs": [
        2
      ],
      "name": "Alexis Tabah"
    },
    {
      "affs": [
        10
      ],
      "name": "Jayshree Lavana"
    },
    {
      "affs": [
        0
      ],
      "name": "Mahesh Ramanan"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/dd1qyjp5hp5jh.bib",
  "cited_by": 0,
  "doi": "10.1016/j.ccrj.2026.100228",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13721007/?tool=EBI",
  "id": "dd1qyjp5hp5jh",
  "issns": [
    "1441-2772",
    "2652-9335"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13721007",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2706|Intensive Care Unit Cognitive Disorders"
    ]
  ],
  "openalex": "W7223403225",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13721007/pdf/?tool=EBI",
  "pmcid": "PMC13721007",
  "pmid": "42965029",
  "published": "2026-10-23",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/dd1qyjp5hp5jh.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:21:37Z",
      "native_id": "PMC:PMC13721007",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13721007"
    },
    {
      "first_seen": "2026-11-03T12:21:46Z",
      "native_id": "PMC13721007",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.ccrj.2026.100228"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2706|Intensive Care Unit Cognitive Disorders",
      "subfield": "general"
    }
  ],
  "title": "Components of institution-free days as a composite outcome after critical illness: A retrospective cohort study",
  "title_text": "Components of institution-free days as a composite outcome after critical illness: A retrospective cohort study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T12:21:46Z",
  "url": "https://research.draconitic.com/paper/dd1qyjp5hp5jh",
  "venue": "Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine",
  "versions": []
}