Predictors of 24-h mortality after inter-hospital transfer to a tertiary medical intensive care unit

Abstract

Purpose: To identify variables associated with 24-h mortality after inter-hospital transfer. Materials and methods: Single center retrospective study of adult patients transferred to a tertiary care medical ICU between 1 January 2010 and 15 April 2014. Demographic, clinical, physiologic, and laboratory data were collected. The Lasso method was used for logistic regression to identify predictors of 24-h mortality after inter-hospital ICU transfer. Results: We identified 773 patients. Median age was 58 years (IQR 45–69), 49% were female, 83% Caucasian, and 48% had Medicare. The median length of stay at the transferring facility was 1.0 day (IQR 0–2). Median SOFA score on the day of ICU transfer was 5 (IQR 2–8). Twenty-two (3%) died within 24 h after inter-hospital transfer. SOFA score of 12–16 the day of inter-hospital transfer (odds ratio (OR) 7.77, 95% CI 1.21–66.26, p = 0.037), FiO2 0.8–1.0 on ICU arrival, and cardiac arrest prior to transfer (OR 4.94, 95% CI 1.43–15.96, p = 0.009) were associated with an increased risk for 24-h mortality after inter-hospital transfer. Conclusions: Our study identified biologically plausible and potentially modifiable factors associated with 24-h mortality after inter-hospital medical ICU transfer, which may serve to inform patients and families of readiness and risk for mortality after inter-hospital transfer.