ArticleCritical care medicine2017
Case Volume-Outcomes Associations Among Patients With Severe Sepsis Who Underwent Interhospital Transfer.
Article in Critical care medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Impact of hospital sepsis case volume on mortality in sepsis patients: a meta-analysis.Frontiers in medicine · 2026Review
- The association between interhospital transfer and sepsis guideline adherence among rural emergency department patients.PloS one · 2026Article
- Effect of Inter-Hospital Transfer on Mortality in Patients Admitted through the Emergency Department.Journal of clinical medicine · 2024Article
- Patient and Hospital Characteristics Associated With the Interhospital Transfer of Adult Patients With Sepsis.Critical care explorations · 2023Article
- The Relationship Between Hospital Capability and Mortality in Sepsis: Development of a Sepsis-Related Hospital Capability Index.Critical care medicine · 2023Article
- Outcomes Associated With Rural Emergency Department Provider-to-Provider Telehealth for Sepsis Care: A Multicenter Cohort Study.Annals of emergency medicine · 2023Article
- Concept review of regionalized systems of acute care: Is regionalization the next frontier in sepsis care?Journal of the American College of Emergency Physicians open · 2022Article
- The Role of a Statewide Critical Care Coordination Center in the Coronavirus Disease 2019 Pandemic-and Beyond.Critical care explorations · 2021Article
- Impact of ICU transfers on the mortality rate of patients with COVID-19: insights from comprehensive national database in France.Annals of intensive care · 2021Article
- Double inter-hospital transfer in Sepsis patients presenting to the ED does not worsen mortality compared to single inter-hospital transfer.Journal of critical care · 2020Article
- Central Venous Access Capability and Critical Care Telemedicine Decreases Inter-Hospital Transfer Among Severe Sepsis Patients: A Mixed Methods Design.Critical care medicine · 2019Article
- Hospital Variation in Risk-Adjusted Pediatric Sepsis Mortality.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2018Article
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Abstract
objectivesCase volume-outcome associations bolster arguments to regionalize severe sepsis care, an approach that may necessitate interhospital patient transfers. Although transferred patients may most closely reflect care processes involved with regionalization, associations between sepsis case volume and outcomes among transferred patients are unclear. We investigated case volume-outcome associations among patients with severe sepsis transferred from another hospital.
designSerial cross-sectional study using the Nationwide Inpatient Sample.
settingUnited States nonfederal hospitals, years 2003-2011. PATIENTS: One hundred forty-one thousand seven hundred seven patients (weighted national estimate of 717,732) with severe sepsis transferred from another acute care hospital.
interventionsNone. MEASUREMENTS AND MAIN
resultsWe examined associations between quintiles of annual hospital severe sepsis case volume for the receiving hospital and in-hospital mortality among transferred patients with severe sepsis. Secondary outcomes included hospital length of stay and total charges. Transferred patients accounted for 13.2% of hospitalized severe sepsis cases. In-hospital mortality was 33.2%, with median length of stay 11 days (interquartile range, 5-22), and median total charge $70,722 (interquartile range, $30,591-$159,013). Patients transferred to highest volume hospitals had higher predicted mortality risk, greater number of acutely dysfunctional organs, and lower adjusted in-hospital mortality when compared with the lowest-volume hospitals (odds ratio, 0.80; 95% CI, 0.67-0.90). In stratified analysis (p < 0.001 for interaction of case volume by organ failure), mortality benefit associated with case volume was limited to patients with single organ dysfunction (n = 48,607, 34.3% of transfers) (odds ratio, 0.66; 95% CI, 0.55-0.80). Treatment at highest volume hospitals was significantly associated with shorter adjusted length of stay (incidence rate ratio, 0.86; 95% CI, 0.75-0.98) but not costs (% charge difference, 95% CI: [-]18.8, [-]37.9 to [+]0.3).
conclusionsHospital mortality was lowest among patients with severe sepsis who were transferred to high-volume hospitals; however, case volume benefits for transferred patients may be limited to patients with lower illness severity.
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