Mortality risk increases with slow ICU transfers

Delayed transfer of hospitalized patients to the intensive care unit significantly increases the risk of dying in the hospital, according to new findings from the University of Chicago Medical Center.

The researchers looked at outcomes after delayed transfer to the ICU and concluded that for every hour transfer was stalled, the odds of dying in the ICU increased 7 percent.

That puts the ICU mortality at 21 percent for patients with six hours from first reaching the Cardiac Arrest Risk Triage (CART) score--a vital sign-based early warning value--until transfer to the ICU, and 52 percent for patients transferred between 18 and 24 hours after the critical value, according to the study findings to be presented at the American Thoracic Society  2013 International Conference.

"Use of an early warning score such as the CART score would allow for earlier identification of these patients and help decrease preventable in-hospital deaths associated with delayed transfer of ward patients to the ICU," lead author Matthew Churpek, M.D., of the University of Chicago Medical Center said in a statement.

Such findings are important as emergency physicians are sending more patients to ICUs than ever before, according to a May study by George Washington University School of Public Health and Health Services (SPHHS) and published in the journal Academic Emergency Medicine.

Co-author Jesse Pines, M.D., a practicing emergency physician and an associate professor of emergency medicine and health policy at SPHHS, echoed concerns about delayed ICU transfers.

"Studies have shown that the longer ICU patients stay in the emergency department, the more likely they are to die in the hospital," Pines, a FierceHealthcare Editorial Advisory Board member, said last week in a statement. "Better coordination between the emergency department and ICU staff might help speed transfers and prevent complications caused by long emergency department waits."

To learn more:
- here's the research announcement and abstract

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