Objectives: The outcomes of critically ill patients who undergo interhospital transfer are not well understood. Physicians assume that patients who undergo interhospital transfer will receive more advanced care that may translate into decreased morbidity or mortality relative to a similar patient who is not transferred. However, there is little empirical evidence to support this assumption. We examined country-level U.S. data from the Nationwide Readmissions Database to examine whether, in mechanically ventilated patients with sepsis, interhospital transfer is associated with a mortality benefit. Design: Retrospective data analysis using complex survey design regression methods with propensity score matching. Setting: The Nationwide Readmissions Database contains information about hospital admissions from 22 States, accounting for roughly half of U.S. hospitalizations; the database contains linkage numbers so that admissions and transfers for the same patient can be linked across 1 year of follow-up. Patients: From the 2013 Nationwide Readmission Database Sample, 14,325,172 hospital admissions were analyzed. There were 61,493 patients with sepsis and on mechanical ventilation. Of these, 1,630 patients (2.7%) were transferred during their hospitalization. A propensity-matched cohort of 1,630 patients who did not undergo interhospital transfer was identified. Interventions: None. Measurements and Main Results: The exposure of interest was interhospital transfer to an acute care facility. The primary outcome was hospital mortality; the secondary outcome was hospital length of stay. The propensity score included age, gender, insurance coverage, do not resuscitate status, use of renal replacement therapy, presence of shock, and Elixhauser comorbidities index. After propensity matching, interhospital transfer was not associated with a difference in in-hospital mortality (12.3% interhospital transfer vs 12.7% non–interhospital transfer; p = 0.74). However, interhospital transfer was associated with a longer total hospital length of stay (12.8 d interquartile range, 7.7–21.6 for interhospital transfer vs 9.1 d interquartile range, 5.1–17.0 for non–interhospital transfer; p
from Emergency Medicine via xlomafota13 on Inoreader http://ift.tt/2yNS4LN
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
Δημοφιλείς αναρτήσεις
-
Champion EMS is currently seeking a Communications Center Manager. Champion EMS is based out of Longview, Texas, serving the East Texas area...
-
from EMS via xlomafota13 on Inoreader http://ift.tt/2sbML2K
-
The name of the second author of this article was incorrectly presented as "Riccardo Scarpa Cosimo" this should have been "Co...
-
Abstract Given shifting sex work criminalization and enforcement in Canada, this study examined worrying about workplace inspections by au...
-
Abstract Introduction In recent years, platelet-rich plasma (PRP) has emerged as a promising autologous biological treatment modality fo...
-
Abstract Background Permissive hypotensive resuscitation (PHR) is an advancing concept aiming towards deliberative balanced resuscitation ...
-
from EMS via xlomafota13 on Inoreader http://ift.tt/2sbML2K
-
While the psychiatric disorders are conditions frequently encountered in hospitalized patients, there are little or no data regarding the ch...
-
No abstract available from Emergency Medicine via xlomafota13 on Inoreader https://ift.tt/2Tlj4K7
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου