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• W4313220721 abstract "Introduction: The interhospital transfer of sepsis patients to better capable hospitals has the potential to improve outcomes but may inadvertently worsen outcomes due to care potential care delays. We sought to determine temporal trends in (i) the prevalence of interhospital transfer among adult patients with sepsis and (ii) hospital mortality among transferred patients with sepsis. Methods: We performed a serial cross-sectional study of adult (≥ 18 years) sepsis hospital encounters between October 2015 and December 2019, using the Florida State In-Patient Databases. Our primary exposure variable was time, based on calendar-year quarters. Our primary outcome was interhospital transfer. Our secondary outcome was hospital mortality among transferred patients. We collected data on age, gender, race, severity of illness (using the Elixhauser comorbidity index), primary insurance payer, median income in Zip code of residence, and rurality of residence. We used multivariable regression models with generalized estimating equations, adjusted for patient demographic and clinical covariates, and with specified Poisson distribution with robust variance estimates, to estimate quarterly risk ratios and adjusted rates for our primary and secondary outcomes. We used the 4th quarter of 2015 as the reference year. Results: Among 480,491 sepsis hospitalizations over the study period, 207,384 (43.2%) were transferred. The demographic and clinical characteristics among transferred patients changed significantly over the study period, with the exception of the Elixhauser comorbidity index. Risk-adjusted rates of interhospital transfer increased over the study period (43.0% in 2016Q1, 47.4% in 2019Q4, average increase 1% per quarter; P for trend <.001). Among transferred patients, risk-adjusted hospital mortality also increased over the study period (2.7% in 2016Q1, 3.9% in 2019Q4, average increase 2.5% per quarter; P for trend .03). Conclusions: Roughly half of adult sepsis encounters in Florida involve interhospital transfer. The rate of transfer of sepsis patients and mortality rates among transferred sepsis patients has increased significantly over time. Comparative studies of the effectiveness of interhospital transfer among sepsis patients are needed to better justify this practice." @default.
• W4313220721 created "2023-01-06" @default.
• W4313220721 creator A5051835984 @default.
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• W4313220721 date "2022-12-15" @default.
• W4313220721 modified "2023-09-25" @default.
• W4313220721 title "266: INTERHOSPITAL TRANSFER TRENDS AMONG ADULT PATIENT WITH SEPSIS IN FLORIDA" @default.
• W4313220721 doi "https://doi.org/10.1097/01.ccm.0000906800.81597.7c" @default.
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