PURPOSE: The study aimed to examine the effect of interhospital transfer on resource utilization and clinical outcomes at a tertiary pediatric intensive care unit (PICU) among patients with sepsis or respiratory failure. MATERIALS AND METHODS: Data on 2146 consecutive admissions with respiratory failure or sepsis to the PICU were analyzed. Data included demographics, admission source, and outcomes. Admission source was classified as interhospital transfer from the emergency departments (ED), wards, or PICUs of referring hospitals; or from the study hospital ED (direct). RESULTS: Compared with direct admissions, inter-PICU transfers had higher crude mortality (odds ratio, 1.93; 95% confidence interval, 1.31-2.84) but not significant mortality difference (odds ratio, 1.16; 95% confidence interval, 0.71-1.86) after adjusting for illness severity, age, and sex. Conversely, ED transfers had lower PICU mortality than direct ED admissions. Children with transfer admissions stayed significantly longer and used more intensive care technology in the study PICU than children directly admitted (P < .01). In comparisons within quartiles of mortality risk, inter-PICU transfers had longer hospitalization and higher mortality in all but the highest quartile. CONCLUSIONS: Interhospital transfer, particularly inter-PICU transfer, was associated with significant hospital resource consumption that often correlated with admission illness severity. Future prospective studies should identify determinants of pretransfer illness severity and investigate decision making underlying interhospital transfer.
PURPOSE: The study aimed to examine the effect of interhospital transfer on resource utilization and clinical outcomes at a tertiary pediatric intensive care unit (PICU) among patients with sepsis or respiratory failure. MATERIALS AND METHODS: Data on 2146 consecutive admissions with respiratory failure or sepsis to the PICU were analyzed. Data included demographics, admission source, and outcomes. Admission source was classified as interhospital transfer from the emergency departments (ED), wards, or PICUs of referring hospitals; or from the study hospital ED (direct). RESULTS: Compared with direct admissions, inter-PICU transfers had higher crude mortality (odds ratio, 1.93; 95% confidence interval, 1.31-2.84) but not significant mortality difference (odds ratio, 1.16; 95% confidence interval, 0.71-1.86) after adjusting for illness severity, age, and sex. Conversely, ED transfers had lower PICU mortality than direct ED admissions. Children with transfer admissions stayed significantly longer and used more intensive care technology in the study PICU than children directly admitted (P < .01). In comparisons within quartiles of mortality risk, inter-PICU transfers had longer hospitalization and higher mortality in all but the highest quartile. CONCLUSIONS: Interhospital transfer, particularly inter-PICU transfer, was associated with significant hospital resource consumption that often correlated with admission illness severity. Future prospective studies should identify determinants of pretransfer illness severity and investigate decision making underlying interhospital transfer.
Authors: Folafoluwa O Odetola; Sarah J Clark; James G Gurney; Janet E Donohue; Achamyeleh Gebremariam; Lindsay DuBois; Gary L Freed Journal: J Crit Care Date: 2015-06-16 Impact factor: 3.425
Authors: Jesus A Serra; Franco Díaz; Pablo Cruces; Cristobal Carvajal; Maria J Nuñez; A Donoso; J A Bravo-Serrano; M Carbonell; C Courtie; A Fernández; L Martínez-Arroyo; J Martínez; S Menta; Luis Pedrozo-Ortiz; A Wegner; Nicolas Monteverde-Fernández; Juan C Jaramillo-Bustamante; Roberto Jabornisky; Sebastián González-Dambrauskas; Sapna R Kudchadkar; Pablo Vásquez-Hoyos Journal: J Pediatr Intensive Care Date: 2021-05-20
Authors: Christina L Cifra; Cody R Tigges; Sarah L Miller; Nathaniel Curl; Christopher D Monson; Kimberly C Dukes; Heather S Reisinger; Priyadarshini R Pennathur; Dean F Sittig; Hardeep Singh Journal: Appl Clin Inform Date: 2022-05-11 Impact factor: 2.762
Authors: Asgar H Rishu; Abdulaziz S Aldawood; Samir H Haddad; Hani M Tamim; Hasan M Al-Dorzi; Ahmed Al-Jabbary; Abdullah Al-Shimemeri; Muhammad R Sohail; Yaseen M Arabi Journal: Ann Intensive Care Date: 2013-08-11 Impact factor: 6.925