Longer Total Interhospital Transfer Times for Rural Sepsis Patients Not Associated with Increased Mortality.

Area of Science:

• Emergency Medicine
• Critical Care Medicine
• Health Services Research

Background:

• Sepsis is a life-threatening condition requiring timely intervention.
• Rural emergency departments (EDs) often lack resources, necessitating interhospital transfers for sepsis patients.
• Understanding the impact of transfer times on patient outcomes is crucial for optimizing care.

Purpose of the Study:

• To investigate the association between interhospital transfer times and sepsis patient outcomes.
• To determine if longer transport durations correlate with increased mortality or hospital length-of-stay (LOS) in rural sepsis patients.

Main Methods:

• A cohort of 359 rural adult sepsis patients transferred between hospitals was analyzed.
• Data collected included rural ED length-of-stay (LOS), transport duration, and total transfer time.
• Statistical models (zero-inflated negative binomial and logit) were used to assess outcomes like 28-day hospital-free days and Surviving Sepsis Campaign (SSC) bundle adherence.

Main Results:

• No significant association was found between ED LOS, transport duration, or total transfer time and 28-day hospital-free days.
• Secondary outcomes, including Surviving Sepsis Campaign (SSC) bundle adherence and in-hospital mortality, also showed no association with transfer time metrics.

Conclusions:

• Longer interhospital transfer times were not associated with adverse outcomes in rural sepsis patients.
• Further research is needed to optimize sepsis care for transferred patients in rural settings.