Interhospital transfer for acute surgical care: does delay matter?

Area of Science:

• Surgical Care
• Emergency Medicine
• Healthcare Management

Background:

• Delays in definitive care are linked to adverse outcomes in trauma and medical emergencies.
• The impact of inter-hospital transfer delays on outcomes for non-traumatic acute surgical conditions remains unclear.

Purpose of the Study:

• To investigate the association between inter-hospital transfer delays and outcomes in patients with non-traumatic acute surgical conditions.
• To determine if transfer delays affect post-transfer mortality or discharge to hospice.

Main Methods:

• Retrospective cohort study of 2,091 patient transfers within a regional network (2009-2013).
• Transfer delay defined as >24 hours from presentation to transfer request (1 or 2+ days).
• Primary outcome: post-transfer death or hospice; analyzed using bivariate and multivariable logistic regression.

Main Results:

• Delays of 2+ days were initially associated with death/hospice but this was not significant after adjustment.
• Older age, higher comorbidity scores, and greater severity of illness predicted post-transfer death or hospice.
• No statistically significant association found between transfer delay and adverse outcomes.

Conclusions:

• Transfer request delays were not associated with increased post-transfer mortality or hospice discharge for non-traumatic acute surgical patients.
• Suggests effective triage systems are in place for these patients within the transfer network.