Demographics and outcomes of critically ill patients transferred from other hospitals to a tertiary care academic referral center in Saudi Arabia

Abstract

BackgroundThe objective of this study was to examine the outcomes of critically ill patients who were transferred from other hospitals to a tertiary care center in Saudi Arabia as a quality improvement project.MethodsThis was a retrospective study of adult patients admitted to the medical-surgical intensive care unit (ICU) of a tertiary care hospital. Patients were divided according to the source of referral into three groups: transfers from other hospitals, and direct admissions from emergency department (ED) and from hospital wards. Standardized mortality ratio (SMR) was calculated. Multivariate analysis was performed to determine the independent predictors of mortality.ResultsOf the 7,654 patients admitted to the ICU, 611 patients (8%) were transferred from other hospitals, 2,703 (35.3%) were direct admissions from ED and 4,340 (56.7%) from hospital wards. Hospital mortality for patients transferred from other hospitals was not significantly different from those who were directly admitted from ED (35% vs. 33.1%, p = 0.37) but was lower than those who were directly admitted from hospital wards (35% vs. 51.2%, p < 0.0001). SMRs did not differ significantly across the three groups.ConclusionsCritically ill patients who were transferred from other hospitals constituted 8% of all ICU admissions. Mortality of these patients was similar to patients with direct admission from the ED and lower than that of patients with direct admission from hospital wards. However, risk-adjusted mortality was not different from the other two groups.

Modeling and optimization of resources in multi-emergency department settings with patient transfer

“…To linearize equation (14), it needs to be presented using Eqs. (15) and (16). Overtime is calculated using Eq.…”

“…To the best of the authors' knowledge, this is the first time that this issue is studied in a systematic way by proposing the mathematical model to capture the impact on patient wait times. It should be noted that some studies investigated patient transfers based on real data available for hospitals in Hong Kong [15], Saudi Arabia [16], and the US [17]. However, no unique model has been presented to formulate these relations between hospitals thus far.…”

Impact of interhospital transfer on emergency department timeliness of care and in-hospital outcomes of adult non-trauma patients

“…Non-trauma patients who present to the ED from IHT and non-IHT exhibit different properties [ 7 , 8 ]. As such, much interest has been paid to investigate the differences in various clinical outcomes between these two patient groups [ [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] ]. However, from the perspective of ED care, one important issue remains to be addressed.…”

“…Previous studies comparing clinical outcomes in non-trauma patients from IHT and non-IHT focused on specialized conditions, such as surgery [ [9] , [10] , [11] ], stroke [ [12] , [13] , [14] ], acute myocardial infarction [ [15] , [16] , [17] , [18] ], critical illness [ [17] , [18] , [19] , [20] ], acute kidney injury [ 21 ], and severe sepsis [ 22 ]. In these studies, non-trauma patients were inter-transferred to referral special care units [ [9] , [10] , [11] , 15 , 18 , 19 ], or their data were collected from registry or healthcare datasets [ 7 , 8 , [12] , [13] , [14] , 16 , 17 , 21 , 22 ]. As such, these studies focused on clinical outcomes, such as hospital length of stay (LOS) [ [8] , [9] , [10] , 20 ], functional outcomes [ 12 , 14 ], mortality [8] , [9] , [11] , [12] , [13] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , and medical cost [ 8 , 9 , 20 , 22 ].…”

“…In these studies, non-trauma patients were inter-transferred to referral special care units [ [9] , [10] , [11] , 15 , 18 , 19 ], or their data were collected from registry or healthcare datasets [ 7 , 8 , [12] , [13] , [14] , 16 , 17 , 21 , 22 ]. As such, these studies focused on clinical outcomes, such as hospital length of stay (LOS) [ [8] , [9] , [10] , 20 ], functional outcomes [ 12 , 14 ], mortality [8] , [9] , [11] , [12] , [13] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , and medical cost [ 8 , 9 , 20 , 22 ]. To this end, the ED timeliness of care is an effective indicator of the ED performance and operational efficiency and can be measured by ED LOS [ 23 , 24 ], which is defined as the time interval from patient arrival to leaving the ED [ 25 ].…”