Carolinas Medical Center, Department of Surgery, 1000 Blythe Blvd, Charlotte, NC, 28203, United States.
Center for Outcomes Research and Evaluation, 1540 Garden Terrace, Charlotte, NC, 28203, United States.
Am J Surg. 2018 Oct;216(4):787-792. doi: 10.1016/j.amjsurg.2018.07.055. Epub 2018 Aug 15.
Emergency general surgery (EGS) admissions account for more than 3 million hospitalizations in the US annually. We aim to better understand characteristics and mortality risk for EGS interhospital transfer patients compared to EGS direct admissions.
Using the 2002-2011 Nationwide Inpatient Sample we identified patients aged ≥18 years with an EGS admission. Patient demographics, hospitalization characteristics, rates of operation and mortality were compared between patients with interhospital transfer versus direct admissions.
Interhospital transfers comprised 2% of EGS admissions. Interhospital transfers were more likely to be white, male, Medicare insured, and had higher rates of comorbidities. Interhospital transfers underwent more procedures/surgeries and had a higher mortality rate. Mortality remained elevated after controlling for patient characteristics.
Interhospital transfers are at higher risk of mortality and undergo procedures/surgeries more frequently than direct admissions. Identification of contributing factors to this increased mortality may identify opportunities for decreasing mortality rate in EGS transfers.
美国每年有超过 300 万例急诊普通外科（EGS）住院患者。我们旨在更好地了解与 EGS 直接入院患者相比，EGS 院内转科患者的特征和死亡风险。
我们使用 2002-2011 年全国住院患者样本，确定了年龄≥18 岁的 EGS 入院患者。比较了院内转科患者与直接入院患者的患者人口统计学、住院特征、手术率和死亡率。
院内转科患者占 EGS 入院患者的 2%。与直接入院患者相比，院内转科患者更可能是白人、男性、医疗保险覆盖，且合并症发生率更高。院内转科患者接受了更多的手术/外科治疗，死亡率也更高。在控制了患者特征后，死亡率仍然较高。
与直接入院患者相比，院内转科患者的死亡率更高，接受手术/外科治疗的频率更高。确定导致这种死亡率增加的因素可能为降低 EGS 转科患者的死亡率提供机会。
