Interhospital transfer for emergency general surgery: An independent predictor of mortality.
BACKGROUND
Emergency general surgery (EGS) admissions account for more than 3 million hospitalizations in the US annually. We aim to better understand characteristics and mortality risk for EGS interhospital transfer patients compared to EGS direct admissions.


METHODS
Using the 2002-2011 Nationwide Inpatient Sample we identified patients aged ≥18 years with an EGS admission. Patient demographics, hospitalization characteristics, rates of operation and mortality were compared between patients with interhospital transfer versus direct admissions.


RESULTS
Interhospital transfers comprised 2% of EGS admissions. Interhospital transfers were more likely to be white, male, Medicare insured, and had higher rates of comorbidities. Interhospital transfers underwent more procedures/surgeries and had a higher mortality rate. Mortality remained elevated after controlling for patient characteristics.


CONCLUSIONS
Interhospital transfers are at higher risk of mortality and undergo procedures/surgeries more frequently than direct admissions. Identification of contributing factors to this increased mortality may identify opportunities for decreasing mortality rate in EGS transfers.
['Yelverton|Sam|S|', 'Rozario|Nigel|N|', 'Matthews|Brent D|BD|', 'Reinke|Caroline E|CE|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D016208:Databases, Factual D004630:Emergencies D005260:Female D013502:General Surgery D006801:Humans D008297:Male D008875:Middle Aged D015999:Multivariate Analysis D010343:Patient Admission D010360:Patient Transfer D012307:Risk Factors D013514:Surgical Procedures, Operative D014481:United States D055815:Young Adult
Interhospital transfer Emergency general surgery Mortality Regionalization