Evidence map›Paper›PMID 40838914›Full record

ArticleJACC. Advances2025

In-Hospital Mortality Risk Among Transfers to Cardiac Intensive Care Units.

Nicholas Phreaner, Miguel Alvarez Villela, Courtney E Bennett, Benjamin B Kenigsberg, Xuan Ding, Rasheed O Durowoju, Anna Fenerty, Boyangzi Li, Miguel A Martillo Correa, Venu Menon and 6 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Advances, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Nicholas PhreanerDivision of Cardiovascular Medicine, Department of Medicine, University of California, San Diego, La Jolla, California, USA. Electronic address: nphreaner@health.ucsd.edu.
Miguel Alvarez VillelaLenox Hill Hospital, Northwell Health, New York, New York, USA.
Courtney E BennettDepartment of Cardiology, Lehigh Valley Hospital and Health Network, Allentown, Pennsylvania, USA.
Benjamin B KenigsbergDepartment of Medicine, Division of Cardiology, and Department of Critical Care, MedStar Washington Hospital Center, Washington, District of Columbia, USA.
Xuan DingThe Johns Hopkins University, Baltimore, Maryland, USA.
Rasheed O DurowojuDivision of Cardiology, Department of Internal Medicine, University of Washington, Seattle, Washington, USA.
Anna FenertyDivision of Cardiovascular Medicine, Department of Medicine, University of California, San Diego, La Jolla, California, USA.
Boyangzi LiCardiovascular Division, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
Miguel A Martillo CorreaDivision of Cardiovascular Medicine, Department of Medicine, University of California, San Diego, La Jolla, California, USA.
Venu MenonDepartment of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Raunak M NairDepartment of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
L Kristin NewbyDivision of Cardiology, Department of Medicine, Duke Clinical Research Institute, Durham, North Carolina, USA.
Mary-Tiffany OduahDepartment of Internal Medicine, Mayo Clinic School of Graduate Medical Education, Rochester, Minnesota, USA.
Alexander I PapolosDepartment of Medicine, Division of Cardiology, and Department of Critical Care, MedStar Washington Hospital Center, Washington, District of Columbia, USA.
David A MorrowCardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Lori B DanielsDivision of Cardiovascular Medicine, Department of Medicine, University of California, San Diego, La Jolla, California, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients treated in tertiary cardiac intensive care units (CICUs) often arrive via transfer from other hospitals. This "transfer population" is poorly described and has been largely excluded from trials in critical care.

objectivesThe aim of this study was to characterize patients who are transferred from other hospitals to advanced CICUs.

methodsThe Critical Care Cardiology Trials Network is an investigator-initiated network of predominantly North American CICUs. Consecutive CICU admissions during annual 2-month snapshots were submitted to the coordinating center (TIMI Study Group) and stratified by transfer vs nontransfer status. Adjustment was made for age, sex, study site, and Sequential Organ Failure Assessment score.

resultsA total of 21,215 admissions (2017-2023) were included in the analysis. Transfers accounted for 38% of admissions and 42% of patient-CICU-days. The primary reason for admission was more likely to be acute coronary syndrome (36% vs 15% for nontransfers, P < 0.001). Transfers were more likely to have shock (35% vs 32%, P = 0.031) and to receive mechanical ventilation (26% vs 17%, P < 0.001), renal replacement therapy (8% vs 5%, P < 0.001), and invasive monitoring (42% vs 34%, P < 0.001). Transfers with shock more frequently received mechanical circulatory support (15% vs 8%, P < 0.001). In-hospital mortality was higher among transfers, accounting for 44% of all deaths (15% vs 11%, P < 0.001; adjusted OR: 1.15 [1.04-1.27]).

conclusionsTransfers account for more than 1 of 3 admissions to tertiary CICUs, require more complex care, and have higher mortality compared to nontransfers. These findings have implications for designing regional systems of care, hand-off communication, risk-adjusted reporting, and plans of care for this high-risk cohort.

Indexed as

cardiac intensive care unitcardiogenic shockcritical careheart failuremyocardial infarctiontransfer

Identifiers

PMID40838914
PMCPMC12541207

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.