Background: Patients with nontraumatic subdural hemorrhage often require immediate surgical intervention that may not be available at community hospitals and are therefore transferred to tertiary care centers. This study aims to evaluate the effects of interhospital transfer (IHT) on postoperative complications and outcomes following ntSDH.
Methods: The National Surgical Quality Improvement Program (NSQIP) database was queried for patients treated for ntSDH from January 2014 to January 2020. Baseline demographics, clinical characteristics, postoperative complications, and postoperative outcomes compared based on IHT status. Univariate and multivariate logistic regression analyses were performed. Effect sizes in the final model were presented as odds ratio (OR) with associated 95% confidence interval (CI).
Results: Of the 715 included patients, 295 (41.3 %) were in the IHT cohort. Non-IHT patients demonstrated significantly increased progressive renal insufficiency (1.90 % vs 0.00 %, p = 0.043) and 30-day readmission rates (11.9 % vs 6.10 %, p = 0.003) when compared with IHT patients. IHT was associated with significantly increased odds of postoperative sepsis (OR = 1.37, p = 0.009), 30-day mortality (OR = 1.20, p = 0.011), and non-home disposition (OR = 1.14, p = 0.003).
Conclusions: Despite similar baseline characteristics, patients transferred for ntSDH treatment are associated with worse postoperative outcomes. Future studies should be conducted to identifying specific factors associated with IHT and poor outcomes.
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http://dx.doi.org/10.1016/j.jocn.2025.111038 | DOI Listing |
J Crit Care Med (Targu Mures)
October 2024
King Saud Medical City, Riyadh, Ar Riyad, Saudi Arabia.
Background: Inter-hospital transfer is intended to provide access to centralized special care for critically ill patients, when resources in their hospitals are not available. However, an empirical gap exists in available evidence, as outcomes of transferred patients to higher centers are inconsistent.
Method: Single center propensity score matching retrospective observational study.
J Clin Neurosci
January 2025
Ochsner Medical Center, Department of Neurosurgery, Jefferson, LA, United States.
Background: Patients with nontraumatic subdural hemorrhage often require immediate surgical intervention that may not be available at community hospitals and are therefore transferred to tertiary care centers. This study aims to evaluate the effects of interhospital transfer (IHT) on postoperative complications and outcomes following ntSDH.
Methods: The National Surgical Quality Improvement Program (NSQIP) database was queried for patients treated for ntSDH from January 2014 to January 2020.
Acta Paediatr
January 2025
Neonatal Intensive Care Unit, Children's Hospital, ASST Spedali Civili Brescia, Brescia, Italy.
Aim: To quantify and categorise retrospectively all adverse events occurring during unplanned neonatal emergency interhospital transfers conducted by the Transfer Service of the Spedali Civili di Brescia over 3 years.
Methods: The revised data were extracted from specific questionnaires filled out by staff. The events were classified according to an adapted retrieval team model (PANSTAR); the risk level was assessed using an effective risk assessment score.
Clin Exp Emerg Med
January 2025
Department of Emergency Medicine, Jeju National University Hospital, Jeju, Korea.
Objective: Traumatic brain injury (TBI) often occurs alongside injuries to other body regions, worsening patient outcomes. This study aimed to evaluate the impact of concomitant injuries on clinical outcomes in patients with isolated versus non-isolated TBI.
Method: A retrospective cross-sectional analysis was conducted using data from the Emergency Department-based Injury In-depth Surveillance System (EDIIS), encompassing 180,058 TBI patients admitted to 23 tertiary hospitals from January 1, 2020, to December 31, 2022.
Epilepsia
January 2025
Department of Neurology, University of California, San Francisco, San Francisco, California, USA.
Objective: Interhospital transfers for status epilepticus (SE) are common, and some are avoidable and likely lower yield. The use of interhospital transfer may differ in emergency department (ED) and inpatient settings, which contend with differing clinical resources and financial incentives. However, transfer from these two settings is understudied, leaving gaps in our ability to improve the hospital experience, cost, and triage for this neurologic emergency.
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