Sam Yelverton1, Nigel Rozario2, Brent D Matthews3, Caroline E Reinke4. 1. Carolinas Medical Center, Department of Surgery, 1000 Blythe Blvd, Charlotte, NC, 28203, United States. Electronic address: Samuel.yelverton@carolinashealthcare.org. 2. Center for Outcomes Research and Evaluation, 1540 Garden Terrace, Charlotte, NC, 28203, United States. Electronic address: Nigel.rozario@carolinashealthcare.org. 3. Carolinas Medical Center, Department of Surgery, 1000 Blythe Blvd, Charlotte, NC, 28203, United States. Electronic address: Brent.matthews@carolinashealthcare.org. 4. Carolinas Medical Center, Department of Surgery, 1000 Blythe Blvd, Charlotte, NC, 28203, United States. Electronic address: Caroline.E.Reinke@AtriumHealth.org.
Abstract
BACKGROUND: Emergency general surgery (EGS) admissions account for more than 3 million hospitalizations in the US annually. We aim to better understand characteristics and mortality risk for EGS interhospital transfer patients compared to EGS direct admissions. METHODS: Using the 2002-2011 Nationwide Inpatient Sample we identified patients aged ≥18 years with an EGS admission. Patient demographics, hospitalization characteristics, rates of operation and mortality were compared between patients with interhospital transfer versus direct admissions. RESULTS: Interhospital transfers comprised 2% of EGS admissions. Interhospital transfers were more likely to be white, male, Medicare insured, and had higher rates of comorbidities. Interhospital transfers underwent more procedures/surgeries and had a higher mortality rate. Mortality remained elevated after controlling for patient characteristics. CONCLUSIONS: Interhospital transfers are at higher risk of mortality and undergo procedures/surgeries more frequently than direct admissions. Identification of contributing factors to this increased mortality may identify opportunities for decreasing mortality rate in EGS transfers.
BACKGROUND: Emergency general surgery (EGS) admissions account for more than 3 million hospitalizations in the US annually. We aim to better understand characteristics and mortality risk for EGS interhospital transfer patients compared to EGS direct admissions. METHODS: Using the 2002-2011 Nationwide Inpatient Sample we identified patients aged ≥18 years with an EGS admission. Patient demographics, hospitalization characteristics, rates of operation and mortality were compared between patients with interhospital transfer versus direct admissions. RESULTS: Interhospital transfers comprised 2% of EGS admissions. Interhospital transfers were more likely to be white, male, Medicare insured, and had higher rates of comorbidities. Interhospital transfers underwent more procedures/surgeries and had a higher mortality rate. Mortality remained elevated after controlling for patient characteristics. CONCLUSIONS: Interhospital transfers are at higher risk of mortality and undergo procedures/surgeries more frequently than direct admissions. Identification of contributing factors to this increased mortality may identify opportunities for decreasing mortality rate in EGS transfers.
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