Inter-hospital Transfers of the Critically Ill: Time Spent at Referring Institutions Influences Survival

Inter-hospital Transfers of the Critically Ill: Time Spent at Referring Institutions Influences Survival

Abstract Objective To determine if the length of stay at a referring institution ICU prior to transfer to a tertiary/quaternary care facility is a risk factor for mortality. Design. We performed a retrospective chart review of patients transferred to our ICU from referring institution ICUs over a th...

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Veröffentlicht in:Journal of critical care 2016
Hauptverfasser: Hanane, Tarik, M.D, Wiles, Samuel, M.D, Senussi, Mourad H, M.D, Han, Xiaozhen, MS, Wang, Xiao-Feng, Ph.D, Duncan Hite, R., M.D, Guzman, Jorge A, M.D
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Critical Care
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container_title Journal of critical care
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creator Hanane, Tarik, M.D
Wiles, Samuel, M.D
Senussi, Mourad H, M.D
Han, Xiaozhen, MS
Wang, Xiao-Feng, Ph.D
Duncan Hite, R., M.D
Guzman, Jorge A, M.D
description Abstract Objective To determine if the length of stay at a referring institution ICU prior to transfer to a tertiary/quaternary care facility is a risk factor for mortality. Design. We performed a retrospective chart review of patients transferred to our ICU from referring institution ICUs over a three year period. Logistical regression analysis was performed to determine which factors were independently associated with increased mortality. The primary outcomes were ICU and hospital mortality. Main Results. 1248 patients were included in our study. Length of stay at the referring institution was an independent risk factor for both ICU and hospital mortality (p-value
doi_str_mv 10.1016/j.jcrc.2016.12.016
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Design. We performed a retrospective chart review of patients transferred to our ICU from referring institution ICUs over a three year period. Logistical regression analysis was performed to determine which factors were independently associated with increased mortality. The primary outcomes were ICU and hospital mortality. Main Results. 1248 patients were included in our study. Length of stay at the referring institution was an independent risk factor for both ICU and hospital mortality (p-value &lt;0.0001), with increasing lengths of stay correlating with increased mortality. Each additional day at the referring institution was associated with a 1.04 increase in likelihood of ICU mortality [1.02–1.06 95% CI, p-value =0.001) and a 1.029 [1.01–1.05 95% CI, p-value =0.005)] increase in likelihood of hospital mortality. Conclusions Length of stay at the referring institution prior to transfer is a risk factor for worse outcomes, with longer stays associated with increased likelihood of mortality. Further studies delineating which factors most affect length of stay at referring institutions, though a difficult task, should be pursued.</description><identifier>ISSN: 0883-9441</identifier><identifier>DOI: 10.1016/j.jcrc.2016.12.016</identifier><language>eng</language><subject>Critical Care</subject><ispartof>Journal of critical care, 2016</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,4024,27923,27924,27925</link.rule.ids></links><search><creatorcontrib>Hanane, Tarik, M.D</creatorcontrib><creatorcontrib>Wiles, Samuel, M.D</creatorcontrib><creatorcontrib>Senussi, Mourad H, M.D</creatorcontrib><creatorcontrib>Han, Xiaozhen, MS</creatorcontrib><creatorcontrib>Wang, Xiao-Feng, Ph.D</creatorcontrib><creatorcontrib>Duncan Hite, R., M.D</creatorcontrib><creatorcontrib>Guzman, Jorge A, M.D</creatorcontrib><title>Inter-hospital Transfers of the Critically Ill: Time Spent at Referring Institutions Influences Survival</title><title>Journal of critical care</title><description>Abstract Objective To determine if the length of stay at a referring institution ICU prior to transfer to a tertiary/quaternary care facility is a risk factor for mortality. Design. We performed a retrospective chart review of patients transferred to our ICU from referring institution ICUs over a three year period. Logistical regression analysis was performed to determine which factors were independently associated with increased mortality. The primary outcomes were ICU and hospital mortality. Main Results. 1248 patients were included in our study. Length of stay at the referring institution was an independent risk factor for both ICU and hospital mortality (p-value &lt;0.0001), with increasing lengths of stay correlating with increased mortality. Each additional day at the referring institution was associated with a 1.04 increase in likelihood of ICU mortality [1.02–1.06 95% CI, p-value =0.001) and a 1.029 [1.01–1.05 95% CI, p-value =0.005)] increase in likelihood of hospital mortality. Conclusions Length of stay at the referring institution prior to transfer is a risk factor for worse outcomes, with longer stays associated with increased likelihood of mortality. Further studies delineating which factors most affect length of stay at referring institutions, though a difficult task, should be pursued.</description><subject>Critical Care</subject><issn>0883-9441</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid/><recordid>eNqlT0tOwzAU9AIkyucCXb0LxNhxG1oWbCoQ2ZLsI8t6aV4wTuXnROrtcSRuwGpmpNF8hNhqJbXS1fMoRxedLDOXupQZbsRGHQ6mOO52-k7cM49K6Rdj9hsx1CFhLIaJL5SshzbawD1GhqmHNCCcIiVy1vsr1N6_Qks_CM0FQwKb4AuzN1I4Qx04UZoTTYGz6P2MwSFDM8eFFusfxW1vPePTHz6It4_39vRZYBYLYeycp7A2feMVeZzmGLKv0x2Xneqa9cC6X1dGldX-aP4d8AuD-V_L</recordid><startdate>2016</startdate><enddate>2016</enddate><creator>Hanane, Tarik, M.D</creator><creator>Wiles, Samuel, M.D</creator><creator>Senussi, Mourad H, M.D</creator><creator>Han, Xiaozhen, MS</creator><creator>Wang, Xiao-Feng, Ph.D</creator><creator>Duncan Hite, R., M.D</creator><creator>Guzman, Jorge A, M.D</creator><scope/></search><sort><creationdate>2016</creationdate><title>Inter-hospital Transfers of the Critically Ill: Time Spent at Referring Institutions Influences Survival</title><author>Hanane, Tarik, M.D ; Wiles, Samuel, M.D ; Senussi, Mourad H, M.D ; Han, Xiaozhen, MS ; Wang, Xiao-Feng, Ph.D ; Duncan Hite, R., M.D ; Guzman, Jorge A, M.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-elsevier_clinicalkeyesjournals_1_s2_0_S08839441163026593</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Critical Care</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hanane, Tarik, M.D</creatorcontrib><creatorcontrib>Wiles, Samuel, M.D</creatorcontrib><creatorcontrib>Senussi, Mourad H, M.D</creatorcontrib><creatorcontrib>Han, Xiaozhen, MS</creatorcontrib><creatorcontrib>Wang, Xiao-Feng, Ph.D</creatorcontrib><creatorcontrib>Duncan Hite, R., M.D</creatorcontrib><creatorcontrib>Guzman, Jorge A, M.D</creatorcontrib><jtitle>Journal of critical care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hanane, Tarik, M.D</au><au>Wiles, Samuel, M.D</au><au>Senussi, Mourad H, M.D</au><au>Han, Xiaozhen, MS</au><au>Wang, Xiao-Feng, Ph.D</au><au>Duncan Hite, R., M.D</au><au>Guzman, Jorge A, M.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Inter-hospital Transfers of the Critically Ill: Time Spent at Referring Institutions Influences Survival</atitle><jtitle>Journal of critical care</jtitle><date>2016</date><risdate>2016</risdate><issn>0883-9441</issn><abstract>Abstract Objective To determine if the length of stay at a referring institution ICU prior to transfer to a tertiary/quaternary care facility is a risk factor for mortality. Design. We performed a retrospective chart review of patients transferred to our ICU from referring institution ICUs over a three year period. Logistical regression analysis was performed to determine which factors were independently associated with increased mortality. The primary outcomes were ICU and hospital mortality. Main Results. 1248 patients were included in our study. Length of stay at the referring institution was an independent risk factor for both ICU and hospital mortality (p-value &lt;0.0001), with increasing lengths of stay correlating with increased mortality. Each additional day at the referring institution was associated with a 1.04 increase in likelihood of ICU mortality [1.02–1.06 95% CI, p-value =0.001) and a 1.029 [1.01–1.05 95% CI, p-value =0.005)] increase in likelihood of hospital mortality. Conclusions Length of stay at the referring institution prior to transfer is a risk factor for worse outcomes, with longer stays associated with increased likelihood of mortality. Further studies delineating which factors most affect length of stay at referring institutions, though a difficult task, should be pursued.</abstract><doi>10.1016/j.jcrc.2016.12.016</doi></addata></record>
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title Inter-hospital Transfers of the Critically Ill: Time Spent at Referring Institutions Influences Survival
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