Prognostic factors for short-term patient mortality following interhospital transfers

Abstract

Introduction: The data on short-term mortality among patients following interhospital transfers remain uncertain in the literature, and particularly in Turkey. The aim of this study was to determine the characteristics of interhospital transfer patients and to investigate the factors associated with 72-h mortality. Methods: All interhospital transfer patients aged 16 years and above from a secondary care public hospital were evaluated retrospectively for the period January to December 2018. A total of 34 variables, including age, gender, date of transfer, referring unit, diagnosis, reason for transfer, transfer destination, waiting and transfer time, vitals, the Glasgow Coma Scale, the presence of intubation, cardiopulmonary resuscitation before transfer, and the use of vasopressor medication, were included in the univariate analysis. The factors associated with short-term mortality were identified by multivariate regression analysis. Results: During the 1-year study period, 1216 interhospital transfers were performed. A total of 116 (9.5%) patients died within 72 h following interhospital transfer. Among all the transfers, the median age was 62 (interquartile range, 39–76) years. According to the multivariate analysis, vasopressor use (odds ratio, 3.55; 95% confidence interval: 1.32–9.52), age (odds ratio, 1.01; 95% confidence interval: 1.00–1.03), pulse (odds ratio, 1.01; 95% confidence interval: 1.00–1.02), and diastolic blood pressure (odds ratio, 0.97; 95% confidence interval: 0.95–0.99) were predictive of 72-h mortality following interhospital transfer. Conclusion: Nearly 10% of all the transfers from the secondary care public hospital resulted in mortality within 72 h. Vasopressor use, advanced age, lower diastolic blood pressure, and tachycardia were the most important factors associated with short-term mortality.