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Transfer Status and 90-Day Mortality in Intensive Care Unit Patients With Sepsis: A Propensity Matched Analysis
Megan Ireland1, Anahita Jalilvand2, Kathia Gonzalez-Gallo3
1University of Toledo, School of Medicine, Toledo,OH.
The Journal of Surgical Research
|August 31, 2021
Summary
Transferring sepsis patients to the surgical intensive care unit (SICU) significantly increases mortality risk. Early identification and transfer of high-risk sepsis patients are crucial for improving outcomes.
Area of Science:
- Critical Care Medicine
- Surgical Outcomes
- Sepsis Management
Background:
- Timely sepsis identification and management in surgical patients are critical.
- Patient transfer status can delay optimal treatment, impacting outcomes.
Purpose of the Study:
- To compare in-hospital and 90-day mortality between patients primarily admitted versus transferred into the surgical intensive care unit (SICU).
Main Methods:
- Retrospective review of 1489 sepsis patients (Sepsis III criteria) admitted to a tertiary referral center's SICU (2014-2019).
- Comparison of demographics, comorbidities, and sepsis presentation between transferred (n=696) and primary (n=793) patients.
- Evaluation of in-hospital and 90-day mortality in unmatched and propensity score-matched cohorts.
Main Results:
- Transferred patients had higher rates of obesity, SOFA scores, and vasopressor use.
- Transfer patients exhibited increased respiratory failure, in-hospital mortality (30% vs 17%), and 90-day mortality (36% vs 24%).
- After matching, transfer status was associated with a 75% and 83% increased odds of in-hospital and 90-day mortality, respectively.
Conclusions:
- Transfer status significantly increases the odds of mortality for sepsis patients in the SICU.
- Earlier identification and transfer of high-risk sepsis patients may mitigate the negative impact of transfer status.
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