Predicting Outcomes for Interhospital Transferred Patients of Emergency General Surgery
Background. Interhospital transferred (IHT) emergency general surgery (EGS) patients are associated with high care intensity and mortality. However, prior studies do not focus on patient-level data. Our study, using each IHT patient’s data, aimed to understand the underlying cause for IHT EGS patien...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-01-01
|
| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2022/8137735 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832550179156262912 |
|---|---|
| author | Brandon Cave Daniel Najafali William Gilliam Jackson F. Barr Christian Cain Chris Yum Jamie Palmer Safura Tanveer Emily Esposito Quincy K. Tran |
| author_facet | Brandon Cave Daniel Najafali William Gilliam Jackson F. Barr Christian Cain Chris Yum Jamie Palmer Safura Tanveer Emily Esposito Quincy K. Tran |
| author_sort | Brandon Cave |
| collection | DOAJ |
| description | Background. Interhospital transferred (IHT) emergency general surgery (EGS) patients are associated with high care intensity and mortality. However, prior studies do not focus on patient-level data. Our study, using each IHT patient’s data, aimed to understand the underlying cause for IHT EGS patients’ outcomes. We hypothesized that transfer origin of EGS patients impacts outcomes due to critical illness as indicated by higher Sequential Organ Failure Assessment (SOFA) score and disease severity. Materials and Methods. We conducted a retrospective analysis of all adult patients transferred to our quaternary academic center’s EGS service from 01/2014 to 12/2016. Only patients transferred to our hospital with EGS service as the primary service were eligible. We used multivariable logistic regression and probit analysis to measure the association of patients’ clinical factors and their outcomes (mortality and survivors’ hospital length of stay [HLOS]). Results. We analyzed 708 patients, 280 (39%) from an ICU, 175 (25%) from an ED, and 253 (36%) from a surgical ward. Compared to ED patients, patients transferred from the ICU had higher mean (SD) SOFA score (5.7 (4.5) vs. 2.39 (2), P<0.001), longer HLOS, and higher mortality. Transferring from ICU (OR 2.95, 95% CI 1.36–6.41, P=0.006), requiring laparotomy (OR 1.96, 95% CI 1.04–3.70, P=0.039), and SOFA score (OR 1.22, 95% CI 1.13–1.32, P<0.001) were associated with higher mortality. Conclusions. At our academic center, patients transferred from an ICU were more critically ill and had longer HLOS and higher mortality. We identified SOFA score and a few conditions and diagnoses as associated with patients’ outcomes. Further studies are needed to confirm our observation. |
| format | Article |
| id | doaj-art-f452f4e860df4c3ab09c96cf24e2b63e |
| institution | Kabale University |
| issn | 2090-1313 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-f452f4e860df4c3ab09c96cf24e2b63e2025-02-03T06:07:32ZengWileyCritical Care Research and Practice2090-13132022-01-01202210.1155/2022/8137735Predicting Outcomes for Interhospital Transferred Patients of Emergency General SurgeryBrandon Cave0Daniel Najafali1William Gilliam2Jackson F. Barr3Christian Cain4Chris Yum5Jamie Palmer6Safura Tanveer7Emily Esposito8Quincy K. Tran9University of Maryland School of MedicineThe Research Associate Program in Emergency Medicine and Critical CareThe Research Associate Program in Emergency Medicine and Critical CareThe Research Associate Program in Emergency Medicine and Critical CareThe R Adams Cowley Shock Trauma CenterThe Research Associate Program in Emergency Medicine and Critical CareUniversity of Maryland School of MedicineThe Research Associate Program in Emergency Medicine and Critical CareThe R Adams Cowley Shock Trauma CenterThe R Adams Cowley Shock Trauma CenterBackground. Interhospital transferred (IHT) emergency general surgery (EGS) patients are associated with high care intensity and mortality. However, prior studies do not focus on patient-level data. Our study, using each IHT patient’s data, aimed to understand the underlying cause for IHT EGS patients’ outcomes. We hypothesized that transfer origin of EGS patients impacts outcomes due to critical illness as indicated by higher Sequential Organ Failure Assessment (SOFA) score and disease severity. Materials and Methods. We conducted a retrospective analysis of all adult patients transferred to our quaternary academic center’s EGS service from 01/2014 to 12/2016. Only patients transferred to our hospital with EGS service as the primary service were eligible. We used multivariable logistic regression and probit analysis to measure the association of patients’ clinical factors and their outcomes (mortality and survivors’ hospital length of stay [HLOS]). Results. We analyzed 708 patients, 280 (39%) from an ICU, 175 (25%) from an ED, and 253 (36%) from a surgical ward. Compared to ED patients, patients transferred from the ICU had higher mean (SD) SOFA score (5.7 (4.5) vs. 2.39 (2), P<0.001), longer HLOS, and higher mortality. Transferring from ICU (OR 2.95, 95% CI 1.36–6.41, P=0.006), requiring laparotomy (OR 1.96, 95% CI 1.04–3.70, P=0.039), and SOFA score (OR 1.22, 95% CI 1.13–1.32, P<0.001) were associated with higher mortality. Conclusions. At our academic center, patients transferred from an ICU were more critically ill and had longer HLOS and higher mortality. We identified SOFA score and a few conditions and diagnoses as associated with patients’ outcomes. Further studies are needed to confirm our observation.http://dx.doi.org/10.1155/2022/8137735 |
| spellingShingle | Brandon Cave Daniel Najafali William Gilliam Jackson F. Barr Christian Cain Chris Yum Jamie Palmer Safura Tanveer Emily Esposito Quincy K. Tran Predicting Outcomes for Interhospital Transferred Patients of Emergency General Surgery Critical Care Research and Practice |
| title | Predicting Outcomes for Interhospital Transferred Patients of Emergency General Surgery |
| title_full | Predicting Outcomes for Interhospital Transferred Patients of Emergency General Surgery |
| title_fullStr | Predicting Outcomes for Interhospital Transferred Patients of Emergency General Surgery |
| title_full_unstemmed | Predicting Outcomes for Interhospital Transferred Patients of Emergency General Surgery |
| title_short | Predicting Outcomes for Interhospital Transferred Patients of Emergency General Surgery |
| title_sort | predicting outcomes for interhospital transferred patients of emergency general surgery |
| url | http://dx.doi.org/10.1155/2022/8137735 |
| work_keys_str_mv | AT brandoncave predictingoutcomesforinterhospitaltransferredpatientsofemergencygeneralsurgery AT danielnajafali predictingoutcomesforinterhospitaltransferredpatientsofemergencygeneralsurgery AT williamgilliam predictingoutcomesforinterhospitaltransferredpatientsofemergencygeneralsurgery AT jacksonfbarr predictingoutcomesforinterhospitaltransferredpatientsofemergencygeneralsurgery AT christiancain predictingoutcomesforinterhospitaltransferredpatientsofemergencygeneralsurgery AT chrisyum predictingoutcomesforinterhospitaltransferredpatientsofemergencygeneralsurgery AT jamiepalmer predictingoutcomesforinterhospitaltransferredpatientsofemergencygeneralsurgery AT safuratanveer predictingoutcomesforinterhospitaltransferredpatientsofemergencygeneralsurgery AT emilyesposito predictingoutcomesforinterhospitaltransferredpatientsofemergencygeneralsurgery AT quincyktran predictingoutcomesforinterhospitaltransferredpatientsofemergencygeneralsurgery |