Work

Availability and content of discharge summaries for primary care physicians of extracorporeal membrane oxygenation–treated patients: An observational study

Year: 2026

Type: article

Abstract: BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is a complex, costly, and uncommon life-saving treatment for critically ill patients with severe cardiac and/or respiratory failure in intensive care units, though its use has increased in recent years. Survivors frequently experience long-term physical, cognitive, and psychological challenges and require support from a wide range of healthcare providers and facilities, many of whom may have limited experience with ECMO. Timely and comprehensive discharge communication is essential to ensure continuity and quality of care across settings. OBJECTIVES: The aims of this study were to assess the proportion of patients treated with ECMO who had a documented primary care physician or clinic on file and to evaluate the inclusion of clinical information in their hospital discharge summaries. METHODS: This multi-centre retrospective observational study included adults treated with ECMO and discharged alive from four tertiary hospitals between January 1, 2021, and December 31, 2022. Patients who died in hospital or were transferred to another acute facility were excluded. Data were collected through medical records' review and linkage with the EXCEL Registry. RESULTS: Of the 150 participants who met eligibility criteria (mean age: 48 years, 72.7% male), 126 (84%) had a documented primary care physician or clinic. Among the 148 (98.7%) medical discharge summaries, the primary diagnosis was recorded for all participants, ECMO use was recorded for 147 (99.3%) participants, discharge destination for 142 (95.9%), hospital follow-up plans for 136 (91.9%), and ECMO indications for 135 (91.2%). Discharge medications were recorded in 131 (88.5%) cases, and a hospital contact person was provided in 95 (64.2%) cases. In contrast, intensive care unit-specific and ECMO-specific recommendations were reported in only 23 (15.5%) and 8 (5.4%) summaries, respectively. CONCLUSIONS: These findings highlight the need to improve discharge communication to better support primary care physicians in delivering coordinated care following hospital discharge.

Source: Australian Critical Care

DOI: 10.1016/j.aucc.2025.101530