ArticleSurgical endoscopy2016
Acuity, outcomes, and trends in the transfer of surgical patients: a national study.
Article in Surgical endoscopy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 44 citations in OpenAlex.
- The Unfinished Journey After Major Surgery: Interhospital Transfer and Care Fragmentation.World journal of surgery · 2026Article
- Prevalence and Characteristics of Potentially Avoidable Interhospital Transfers.JAMA network open · 2026Article
- Development of a Tool to Measure Potentially Inappropriate Inter-Hospital Transfer (IHT): The POINT Study.Journal of general internal medicine · 2025Article
- Virtual triage from freestanding emergency departments: a propensity score-weighted analysis of short-term outcomes in emergency general surgery.Surgical endoscopy · 2023Article
- Diagnostic accuracy of updated risk assessment criteria and development of novel computational prediction models for patients with suspected choledocholithiasis.Surgical endoscopy · 2023Article
- Documenting surgical triage in rural surgical networks: Formalising existing structures.The Australian journal of rural health · 2022Article
- Interhospital transfer (IHT) in emergency general surgery patients (EGS): A scoping review.Surgery open science · 2022Article
- Complications After Complex Gastrointestinal Cancer Surgery: Benefits and Costs Associated with Inter-hospital Transfer Among Medicare Beneficiaries.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- Factors associated with Interhospital transfers of emergency general surgery patients from emergency departments.The American journal of emergency medicine · 2021Article
- Is it a matter of time? The effect of transfer time on femur fracture outcomes.Trauma surgery & acute care open · 2021Article
- Observational
- Sepsis as the primary admitting diagnosis of transferred patients who died within 48 hours of arrival at a Central Texas hospital.Proceedings (Baylor University. Medical Center) · 2019Article
- Characteristics and Timing of Interhospital Transfers of Emergency General Surgery Patients.The Journal of surgical research · 2019Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionWith the regionalization of surgical care, reduction in the rural workforce, rising healthcare costs, and increasing focus on surgical outcomes, appropriate transfer of surgical patients is an increasingly important aspect of health care. This study examines patients transferred for surgical intervention through a national sample.
methodsThe American College of Surgeons National Surgical Quality Improvement Program database was queried from 2005 to 2012 for surgery patients who were transferred from an outside hospital or emergency department (ED) and compared patients undergoing surgery without transfer. Patients were divided into two time periods (TP): 2005-2008 (TP1) and 2008-2012 (TP2) for analysis; patient characteristics and top CPT codes for each TP were collected. Univariate analysis and matched cohorts were used to compare the groups.
resultsOverall, 61,204 patients were transferred and underwent surgery. The rate of transferred surgery patients increased from 3.2% in TP1 to 4.5% in TP2 (p < 0.0001). Compared to non-transferred patients, transferred patients had higher rates of diabetes (23.4 vs. 17.6%, p < 0.0001), tobacco use (27.9 vs. 20.3%, p < 0.0001), Charlson comorbidity index (mean score 1.5 vs. 0.8, p < 0.0001), preoperative sepsis (32.0 vs. 9.4%, p < 0.0001), and need for emergent surgery (41.3 vs. 14.4%, p < 0.0001). From TP1 to TP2, there was an increase in transferred patients who were obese (33.9-36.4%, p < 0.0001) and had emergent transfers (39.6-41.8%, p < 0.0001), with a decrease in diabetic patients (24.7-23.1%, p < 0.0001). From TP1 to TP2, transferred patients had more minor complications (17.7-31.0%, p < 0.0001), but fewer major complications (32.1-23.9%, p < 0.0001) and lower 30-day mortality (11.8-8.1%, p < 0.0001).
conclusionsPatients transferred for surgery represent a higher acuity population than non-transferred patients, and the number of transfers continues to rise. Even when matched by comorbidities, transferred patients have worse outcomes. Surgical sub-specialization and physician tiering may complicate future transfer practices. Efficient transfers, effective physician communication, and ready availability of medical records are critical in improving patient transfers.
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