Faculty Collaboration Database

Predictors of 24-h mortality after inter-hospital transfer to a tertiary medical intensive care unit. J Intensive Care Soc 2018 Nov;19(4):319-325

Date

12/06/2018

Pubmed ID

30515241

Pubmed Central ID

PMC6259083

DOI

10.1177/1751143718765412

Scopus ID

2-s2.0-85044480213 (requires institutional sign-in at Scopus site)   13 Citations

Abstract

PURPOSE: To identify variables associated with 24-h mortality after inter-hospital transfer.

MATERIALS AND METHODS: Single center retrospective study of adult patients transferred to a tertiary care medical ICU between 1 January 2010 and 15 April 2014. Demographic, clinical, physiologic, and laboratory data were collected. The Lasso method was used for logistic regression to identify predictors of 24-h mortality after inter-hospital ICU transfer.

RESULTS: We identified 773 patients. Median age was 58 years (IQR 45-69), 49% were female, 83% Caucasian, and 48% had Medicare. The median length of stay at the transferring facility was 1.0 day (IQR 0-2). Median SOFA score on the day of ICU transfer was 5 (IQR 2-8). Twenty-two (3%) died within 24 h after inter-hospital transfer. SOFA score of 12-16 the day of inter-hospital transfer (odds ratio (OR) 7.77, 95% CI 1.21-66.26, p = 0.037), FiO₂ 0.8-1.0 on ICU arrival, and cardiac arrest prior to transfer (OR 4.94, 95% CI 1.43-15.96, p = 0.009) were associated with an increased risk for 24-h mortality after inter-hospital transfer.

CONCLUSIONS: Our study identified biologically plausible and potentially modifiable factors associated with 24-h mortality after inter-hospital medical ICU transfer, which may serve to inform patients and families of readiness and risk for mortality after inter-hospital transfer.

Author List

Patel JJ, Kurman J, Al-Ghandour E, Thandra K, Mawari S, Graf J, Kovac J, Rein L, Simpson SQ

Authors

Jonathan S. Kurman MD Assistant Professor in the Medicine department at Medical College of Wisconsin
Jayshil Patel MD Associate Professor in the Medicine department at Medical College of Wisconsin
Lisa E. Rein Biostatistician III in the Institute for Health and Equity department at Medical College of Wisconsin