PMID- 19272546
OWN - NLM
STAT- MEDLINE
DCOM- 20090805
LR  - 20220330
IS  - 1557-8615 (Electronic)
IS  - 0883-9441 (Linking)
VI  - 24
IP  - 1
DP  - 2009 Mar
TI  - Location of patients before transfer to a tertiary care intensive care unit: 
      impact on outcome.
PG  - 108-13
LID - 10.1016/j.jcrc.2008.03.002 [doi]
AB  - OBJECTIVE: To evaluate the impact of the source of patients transferred to a 
      tertiary care intensive care unit (ICU) (referring hospital ICU vs referring 
      hospital emergency department [ED]) on outcomes of transferred patients. DESIGN 
      AND SETTING: We performed a retrospective review of data contained in the Project 
      Impact database of a medical-surgical ICU at a university hospital. PATIENTS AND 
      PARTICIPANTS: A total of 503 patients transferred from local community hospitals, 
      283 from EDs and 220 from ICUs, were identified and included. In addition to 
      comparing all ED transfers with all ICU transfers, comparisons between the 2 
      populations were made for the subgroups of patients with intracranial hemorrhage 
      (group 1), nonhemorrhagic stroke (group 2), and all other patients (group 3). 
      MEASUREMENTS AND RESULTS: Patients were evaluated for a variety of outcome 
      parameters, including mortality and ICU and hospital length of stay (LOS) 
      according to their location at the referring hospital at the time of transfer: 
      ICU (ICUtx) or ED (EDtx). Mortality was significantly lower among EDtx in all 
      transferred patients as well as in groups 2 and 3 with no difference in mortality 
      identified in group 1. Intensive care unit LOS was shorter for EDtx and the 3 
      groups, and hospital LOS was shorter among all EDtx and those in group 3. Group 3 
      EDtx also had lower than predicted mortality. CONCLUSIONS: Transfer of patients 
      to a tertiary care ICU from the ED of a referring hospital is associated with 
      significantly better outcomes than transfers from referring hospital ICUs.
FAU - Gerber, David R
AU  - Gerber DR
AD  - Critical Care Medicine, Cooper University Hospital, Camden, NJ 08103, USA. 
      gerber-dave@cooperhealth.edu
FAU - Schorr, Christa
AU  - Schorr C
FAU - Ahmed, Imtiaz
AU  - Ahmed I
FAU - Dellinger, R Phillip
AU  - Dellinger RP
FAU - Parrillo, Joseph
AU  - Parrillo J
LA  - eng
PT  - Journal Article
DEP - 20080514
PL  - United States
TA  - J Crit Care
JT  - Journal of critical care
JID - 8610642
SB  - IM
MH  - APACHE
MH  - Adult
MH  - Critical Care/organization & administration
MH  - Emergency Service, Hospital
MH  - Health Services Needs and Demand
MH  - Hospital Mortality
MH  - Hospitals, Community
MH  - Hospitals, University
MH  - Humans
MH  - Intensive Care Units/*organization & administration
MH  - Length of Stay/statistics & numerical data
MH  - New Jersey/epidemiology
MH  - Outcome Assessment, Health Care/*organization & administration
MH  - Patient Transfer/*organization & administration
MH  - Referral and Consultation/*organization & administration
MH  - Regression Analysis
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Survival Rate
MH  - Time Factors
MH  - Triage
EDAT- 2009/03/11 09:00
MHDA- 2009/08/06 09:00
CRDT- 2009/03/11 09:00
PHST- 2007/05/16 00:00 [received]
PHST- 2008/01/18 00:00 [revised]
PHST- 2008/03/06 00:00 [accepted]
PHST- 2009/03/11 09:00 [entrez]
PHST- 2009/03/11 09:00 [pubmed]
PHST- 2009/08/06 09:00 [medline]
AID - S0883-9441(08)00066-X [pii]
AID - 10.1016/j.jcrc.2008.03.002 [doi]
PST - ppublish
SO  - J Crit Care. 2009 Mar;24(1):108-13. doi: 10.1016/j.jcrc.2008.03.002. Epub 2008 
      May 14.