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Though often undertaken to provide patients with specialized care, interhospital transfer (IHT) is associated with worse outcomes for select patients. Certain aspects of the transfer process have been suggested as contributors to these outcomes. We performed a retrospective cohort study including patients ≥ 18 years who underwent IHT to a tertiary care hospital between January 2005 and September 2013. We examined the association between "weekend" transfer, "nighttime" transfer, "time delay" between transfer acceptance and arrival, and admission team "busyness" on the day of transfer, and patient outcomes, including transfer to the intensive care unit (ICU) within 48 hours and 30-day mortality. We utilized multivariable logistic regression models, adjusting for patient characteristics. Secondary analyses examined detailed timing of transfer and evaluated 30-day mortality stratified by service of transfer. Among the 24,352 patients who underwent IHT, the nighttime transfer was associated with increased adjusted odds of ICU transfer (odds ratio [OR] 1.54; 95% CI 1.38, 1.72) and 30-day mortality (OR 1.16; 95% CI 1.01, 1.35). Secondary analyses confirmed the association between nighttime transfer and ICU transfer throughout the week and demonstrated that Sunday (and trend towards Friday) night transfers had increased 30-day mortality, as compared with Monday daytime transfer. Stratified analyses demonstrated a significant association between transfer characteristics and adjusted odds of 30-day mortality among cardiothoracic and gastrointestinal surgical service transfers. Our findings suggest high acuity patients have worse outcomes during off-peak times of transfer and during times of high care team workload. Further study is needed to identify underlying reasons to explain these associations and devise potential solutions.
This article was published in the following journal.
Name: Journal of hospital medicine
Transferred emergency general surgery (EGS) patients constitute a highly vulnerable, acutely ill population. Guidelines to facilitate timely, appropriate EGS transfers are lacking. We determined patie...
This study aimed to construct a management model for patient transfer in a multilevel healthcare system and to predict the effect of counseling with nurses on the patient transfer process.
Charge, spin and quantum states transfer in solid state devices is an important issue in quantum information. Adiabatic protocols, such as coherent transfer by adiabatic passage have been proposed for...
Many non-trauma centers perform computed tomography (CT) on injured children prior to transfer to a pediatric trauma center (PTC), but the institutional variability and clinical impact of this practic...
Interhospital Transfer in Low-Volume and High-Volume Emergency Departments and Survival Outcomes after Out-of-Hospital Cardiac Arrest: A Nationwide Observational Study and Propensity Score-Matched Analysis.
Post-resuscitation care of out-of-hospital cardiac arrest (OHCA) patients often involves inter-hospital transfer (IHT). We aimed to determine the association between IHT and outcomes of OHCA.
Prospective, open, randomized, parallel, two-arm trial to compare the clinical pregnancy rate between most commonly used two embryo transfer techniques: trial followed by transfer techniqu...
The purpose of this study is to compare IVF outcomes between day 3 and day 5 embryo transfer in patients with five or fewer embryos in a fresh embryo transfer in vitro fertilization (IVF) ...
The development of in vivo biomarkers sensitive to myelin disruption represents a major clinical need to be able to monitor the demyelination processes as well as the effect of remyelinati...
Dermal transfer efficiency has been defined as the amount of material that moves from one surface to another following contact. The investigators propose to measure dermal transfer effici...
The objective of the present randomized controlled study is to compare clinical effectiveness and safety of freezing all embryos followed by frozen-thawed embryo transfer (FET) compared to...
Interfacility or intrahospital transfer of patients. Intrahospital transfer is usually to obtain a specific kind of care and interfacility transfer is usually for economic reasons as well as type of care provided.
The introduction of functional (usually cloned) GENES into cells. A variety of techniques and naturally occurring processes are used for the gene transfer such as cell hybridization, LIPOSOMES or microcell-mediated gene transfer, ELECTROPORATION, chromosome-mediated gene transfer, TRANSFECTION, and GENETIC TRANSDUCTION. Gene transfer may result in genetically transformed cells and individual organisms.
The transfer of energy of a given form among different scales of motion. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed). It includes the transfer of kinetic energy and the transfer of chemical energy. The transfer of chemical energy from one molecule to another depends on proximity of molecules so it is often used as in techniques to measure distance such as the use of FORSTER RESONANCE ENERGY TRANSFER.
The transfer of bacterial DNA by phages from an infected bacterium to another bacterium. This also refers to the transfer of genes into eukaryotic cells by viruses. This naturally occurring process is routinely employed as a GENE TRANSFER TECHNIQUE.
Enzymes that transfer the ADP-RIBOSE group of NAD or NADP to proteins or other small molecules. Transfer of ADP-ribose to water (i.e., hydrolysis) is catalyzed by the NADASES. The mono(ADP-ribose)transferases transfer a single ADP-ribose. POLY(ADP-RIBOSE) POLYMERASES transfer multiple units of ADP-ribose to protein targets, building POLY ADENOSINE DIPHOSPHATE RIBOSE in linear or branched chains.
Surgery is a technology consisting of a physical intervention on tissues. All forms of surgery are considered invasive procedures; so-called "noninvasive surgery" usually refers to an excision that does not penetrate the structure being exci...