SHM Converge Scientific Abstract ePoster Gallery-Evaluation of Inter-Icu Transfer Practice Patterns: A Tertiary-Care Hospital Experience

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This study examined inter-ICU transfers between hospitals, which are intended to provide higher levels of care but are not standardized and may sometimes be unnecessary or harmful. The authors focused on two suboptimal outcomes: <strong>futile transfers</strong> (patients who died or transitioned to comfort care within 48 hours of transfer) and <strong>low-value transfers</strong> (patients discharged alive from the receiving hospital within 48 hours).

Using a retrospective design, the researchers analyzed adults transferred to a large tertiary-care hospital ICU from January 2014 through December 2017. The sample included <strong>5,769 patients</strong> transferred from <strong>18 hospitals</strong> in North and South Carolina. They used multilevel logistic regression to assess hospital-level variation and calculated the median odds ratio (MOR) to measure differences not explained by patient factors such as age, comorbidity burden, and SOFA score.

Results showed substantial variation across hospitals. The proportion of <strong>potentially futile transfers</strong> ranged from <strong>0% to 11%</strong>, and <strong>low-value transfers</strong> ranged from <strong>9% to 22%</strong>. After adjustment, the MORs were <strong>1.34</strong> for potentially futile transfers and <strong>1.29</strong> for low-value transfers, indicating meaningful variation between hospitals beyond patient characteristics.

The study concludes that there are significant hospital-level differences in inter-ICU transfer practices, with a notable share of transfers appearing low-value or futile. The findings suggest a need for better standardization and clearer guidance on which patients and clinical situations are most appropriate for ICU transfer.

Asset Subtitle

Natalia Arana

Meta Tag

Author List Brice Taylor, Natalia Arana, Shih-Hsiung Chou, Stephanie Taylor

Category Research

Concept Inter-ICU Transfer

Concept Futile Transfer

Concept Patient Outcome

Concept Low-Value Transfer

Concept Retrospective Study

Distinguished Non-Finalist

Presenter Organization University of Michigan Department of Internal Medicine

Presenting Author Natalia Arana

Track Transitions of Care

Keywords

inter-ICU transfers

futile transfers

low-value transfers

intensive care unit

hospital variation

retrospective study

multilevel logistic regression

median odds ratio

tertiary-care hospital

ICU transfer standardization

Inter-ICU Transfer

Futile Transfer

Patient Outcome

Low-Value Transfer

Retrospective Study