Predictors of 24-h mortality after inter-hospital transfer to a tertiary medical intensive care unit. (November 2018)

• Record Type: Journal Article
• Authors: Patel, Jayshil J; Kurman, Jonathan; Al-Ghandour, Easa; Thandra, Krishna; Mawari, Samih; Graf, Jeanette; Kovac, Jennifer; Rein, Lisa; Simpson, Steven Q
• Is Part Of: Journal of the Intensive Care Society. Volume 19:Number 4(2018:Nov.)
• Page Start: 319
• Page End: 325
• Publication Date: 2018-11
• Subjects: Critical care -- outcomes -- inter-hospital transfer -- medical intensive care unit -- organ dysfunction; Critical care medicine -- Periodicals; Intensive care units -- Periodicals; 616.028
• DOI: 10.1177/1751143718765412
• Languages: English
• ISSNs: 1751-1437

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.