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ICU transfer delay and mortality after ward-onset shock.

Tongjuan Zou1, Chansokhon Ngan2, Wanhong Yin1

  • 1Department of Critical Care Medicine, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Wuhou District, Chengdu City, Sichuan Province 610041, China; Visualized Diagnostics and Therapeutics & Artificial Intelligence Laboratory (VDT-AI Lab), West China Hospital, Sichuan University, No. 37, Guoxue Lane, Wuhou District, Chengdu City, Sichuan Province 610041, China.

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|January 11, 2026
PubMed
Summary

Delayed intensive care unit (ICU) transfer for ward-onset shock increases mortality. Early point-of-care ultrasound (POCUS) use is linked to better patient outcomes.

Keywords:
ICU transfer delayIn-hospital mortalityPoint-of-care ultrasoundRapid response systemWard-onset shock

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Area of Science:

  • Critical Care Medicine
  • Emergency Medicine
  • Diagnostic Imaging

Background:

  • Ward-onset shock is a critical condition requiring timely intensive care unit (ICU) admission.
  • Delays in ICU transfer can negatively impact patient outcomes.
  • Point-of-care ultrasound (POCUS) is an increasingly utilized tool in critical care settings.

Purpose of the Study:

  • To investigate the association between intensive care unit (ICU) transfer delay and mortality in patients with ward-onset shock.
  • To determine if early point-of-care ultrasound (POCUS) use is associated with improved patient outcomes in this population.

Main Methods:

  • Retrospective cohort study of 3535 adult patients with ward-onset shock requiring ICU transfer.
  • Analysis of ICU registry and electronic health records from West China Hospital (2019-2024).
  • Comparison of mortality rates based on ICU transfer delay (<3h, 3-6h, >6h) and early POCUS use (within 6h of shock onset).

Main Results:

  • In-hospital mortality was 24.0%, increasing significantly with transfer delay: 18.0% (<3h), 40.7% (3-6h), and 51.5% (>6h).
  • Adjusted odds of in-hospital death were higher for delays of 3-6h (OR 2.34) and >6h (OR 3.27) compared to <3h.
  • Early POCUS use (7.1% of patients) was associated with lower in-hospital (aOR 0.57) and 28-day mortality (aOR 0.47).

Conclusions:

  • ICU transfer delay following ward-onset shock is an independent predictor of increased mortality.
  • Early application of POCUS in patients with ward-onset shock is associated with reduced mortality.
  • These findings highlight the importance of timely ICU transfer and the potential benefit of early POCUS in managing ward-onset shock.