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Comparison of Transferred Versus Nontransferred Pediatric Patients Admitted for Sepsis

Benson S Hsu1, Michelle Schimelpfenig1, Saquib Lakhani1

  • 1Sanford School of Medicine, University of South Dakota, Sioux Falls, SD, USA.

Air Medical Journal
|February 10, 2016
PubMed

Insights

Pediatric sepsis patients transferred to another hospital are more severely ill, have more chronic conditions, and incur higher costs and mortality rates. This highlights disparities in care for these vulnerable children.

Area of Science:

  • Pediatric critical care medicine
  • Healthcare systems research
  • Infectious diseases epidemiology

Background:

  • Limited understanding of characteristics of pediatric patients requiring medical transfer.
  • Need to identify differences between transferred and non-transferred pediatric sepsis cases.

Purpose of the Study:

  • To compare the clinical characteristics and outcomes of pediatric patients admitted with sepsis who were transferred versus those not admitted as transfers.

Main Methods:

  • Retrospective analysis of the 2009 Kids' Inpatient Database.
  • Inclusion criteria: diagnosis of sepsis (APR-DRG 720).
  • Transfer status identified by admission codes; weighted statistical analysis performed.

Main Results:

  • Transferred pediatric sepsis patients exhibited higher severity of illness (45.1% vs. 18.7%), more chronic conditions (2.0 vs. 1.5), and longer hospital stays (10.8 vs. 6.5 days).
  • Higher rates of procedures (2.9 vs. 1.4), mortality (8.4% vs. 3.2%), and increased total ($30,626 vs. $13,677) and daily costs ($2,901 vs. $1,887) were observed in transferred patients.
  • Transfers were more common at teaching hospitals (85.9% vs. 54.8%).

Conclusions:

  • Pediatric patients with sepsis who are transferred are significantly more ill and have greater comorbidities.
  • Transferred sepsis patients experience longer hospitalizations, undergo more procedures, and face higher mortality.
  • Transferring pediatric sepsis patients results in substantially increased healthcare costs.
Abstract

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