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Sjövall, F., Edström, M., Walther, S. M. & Hanberger, H. (2022). A nationwide evaluation of antibiotics consumption in Swedish intensive care units. Infectious Diseases, 54(10), 713-721
Open this publication in new window or tab >>A nationwide evaluation of antibiotics consumption in Swedish intensive care units
2022 (English)In: Infectious Diseases, ISSN 2374-4235, E-ISSN 2374-4243, Vol. 54, no 10, p. 713-721Article in journal (Refereed) Published
Abstract [en]

Background Around 70% of all ICU patients are treated with antibiotics whereas up to 30% are suggested as unnecessary. Measuring antibiotic consumption is a prerequisite to improving its use and the purpose of the present investigation was to explore the use of antibiotics in Swedish ICUs. Material and methods Daily Defined Doses (DDDs) of antimicrobials delivered to Swedish ICUs, 2016-2018, were retrieved from Swedish pharmacies. From the Swedish Intensive Care Registry, we extracted data on a number of patient admissions, occupied bed days and Simplified Acute Physiology Score (SAPS)3. Results There was a similar annual rate of total DDDs per admission of 3.7, 3.5, 3.8 and total DDDs per 100 occupied bed days of 111, 111, and 115 but with an approximately 6-fold difference of DDDs per occupied bed days (61-366) between the ICUs. The most frequently used antibiotics were isoxazolyl penicillins (J01CF), penicillins with betalactamase-inhibitors, mainly piperacillin/tazobactam (J01CR), 3rd and 4th generation cephalosporins (J01DD + DE) and carbapenems (J01DH). Together these four classes accounted for a median of 52% of all antibiotic use. The use of carbapenems had a moderate positive correlation with the mean SAPS3 score (r = 0.6, p = .01). The use of other broad-spectrum antibiotics showed no such correlation. Conclusion Overall antibiotic use remained similar in Swedish ICUs during the years 2016-2018. Broad-spectrum antibiotics accounted for 50% of all DDDs but with a large inter-ICU variation which only partly can be explained by differences in patient case mix and microbial resistance. Presumably, it also reflects varying local prescribing practices.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD, 2022
Keywords
Antibiotics; antimicrobials; intensive care; critical care; antimicrobial stewardship
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-185832 (URN)10.1080/23744235.2022.2081717 (DOI)000803879200001 ()35638173 (PubMedID)
Note

Funding Agencies|Region Skane Research Grant; Vetenskapsradet

Available from: 2022-06-15 Created: 2022-06-15 Last updated: 2023-05-04
Strålin, K., Bruce, D., Wahlström, E., Walther, S. M., Bark, A. M. B., Rehn, M., . . . Hanberger, H. (2022). Impact of the Alpha VOC on disease severity in SARS-CoV-2-positive adults in Sweden [Letter to the editor]. Journal of Infection, 84(1), E3-E5
Open this publication in new window or tab >>Impact of the Alpha VOC on disease severity in SARS-CoV-2-positive adults in Sweden
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2022 (English)In: Journal of Infection, ISSN 0163-4453, E-ISSN 1532-2742, Vol. 84, no 1, p. E3-E5Article in journal, Letter (Other academic) Published
Place, publisher, year, edition, pages
London, United Kingdom: , 2022
National Category
Infectious Medicine
Identifiers
urn:nbn:se:liu:diva-182935 (URN)10.1016/j.jinf.2021.08.043 (DOI)000746999200003 ()34474056 (PubMedID)2-s2.0-85123262677 (Scopus ID)
Available from: 2022-02-18 Created: 2022-02-18 Last updated: 2023-05-04Bibliographically approved
Parenmark, F. & Walther, S. M. (2022). Intensive care unit to unit capacity transfers are associated with increased mortality: an observational cohort study on patient transfers in the Swedish Intensive Care Register. Annals of Intensive Care, 12(1), Article ID 31.
Open this publication in new window or tab >>Intensive care unit to unit capacity transfers are associated with increased mortality: an observational cohort study on patient transfers in the Swedish Intensive Care Register
2022 (English)In: Annals of Intensive Care, ISSN 2110-5820, E-ISSN 2110-5820, Vol. 12, no 1, article id 31Article in journal (Refereed) Published
Abstract [en]

Background: Transfers from one intensive care unit (ICU) to another ICU are associated with increased length of intensive care and hospital stay. Inter-hospital ICU transfers are carried out for three main reasons: clinical transfers, capacity transfers and repatriations. The aim of the study was to show that different ICU transfers differ in risk-adjusted mortality rate with repatriations having the least risk.

Results: Observational cohort study of adult patients transferred between Swedish ICUs during 3 years (2016-2018) with follow-up ending September 2019. Primary and secondary end-points were survival to 30 days and 180 days after discharge from the first ICU. Data from 75 ICUs in the Swedish Intensive Care Register, a nationwide intensive care register, were used for analysis (89% of all Swedish ICUs), covering local community hospitals, district general hospitals and tertiary care hospitals. We included adult patients (16 years or older) admitted to ICU and subsequently discharged by transfer to another ICU. Only the first admission was used. Exposure was discharge to any other ICU (ICU-to-ICU transfer), whether in the same or in another hospital. Transfers were grouped into three predefined categories: clinical transfer, capacity transfer, and repatriation. We identified 15,588 transfers among 112,860 admissions (14.8%) and analysed 11,176 after excluding 4112 repeat transfer of the same individual and 300 with missing risk adjustment. The majority were clinical transfers (62.7%), followed by repatriations (21.5%) and capacity transfers (15.8%). Unadjusted 30-day mortality was 25.0% among capacity transfers compared to 14.5% and 16.2% for clinical transfers and repatriations, respectively. Adjusted odds ratio (OR) for 30-day mortality were 1.25 (95% CI 1.06-1.49 p = 0.01) for capacity transfers and 1.17 (95% CI 1.02-1.36 p = 0.03) for clinical transfers using repatriation as reference. The differences remained 180 days post-discharge.

Conclusions: There was a large proportion of ICU-to-ICU transfers and an increased odds of dying for those transferred due to other reasons than repatriation.

Place, publisher, year, edition, pages
Heideleberg, Germany: Springer, 2022
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:liu:diva-184403 (URN)10.1186/s13613-022-01003-x (DOI)000777984700001 ()35377019 (PubMedID)2-s2.0-85127577182 (Scopus ID)
Note

Funding Agencies: Linköping University; Centre for Research and Development Region Gävleborg, Sweden; Centre for Research and Development Region Östergotland, Sweden

Available from: 2022-04-20 Created: 2022-04-20 Last updated: 2023-05-04Bibliographically approved
Flaatten, H., Guidet, B., Andersen, F. H., Artigas, A., Cecconi, M., Boumendil, A., . . . de Lange, D. W. (2021). Reliability of the Clinical Frailty Scale in very elderly ICU patients: a prospective European study. Annals of Intensive Care, 11(1), Article ID 22.
Open this publication in new window or tab >>Reliability of the Clinical Frailty Scale in very elderly ICU patients: a prospective European study
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2021 (English)In: Annals of Intensive Care, ISSN 2110-5820, E-ISSN 2110-5820, Vol. 11, no 1, article id 22Article in journal (Refereed) Published
Abstract [en]

Purpose Frailty is a valuable predictor for outcome in elderly ICU patients, and has been suggested to be used in various decision-making processes prior to and during an ICU admission. There are many instruments developed to assess frailty, but few of them can be used in emergency situations. In this setting the clinical frailty scale (CFS) is frequently used. The present study is a sub-study within a larger outcome study of elderly ICU patients in Europe (the VIP-2 study) in order to document the reliability of the CFS. Materials and methods From the VIP-2 study, 129 ICUs in 20 countries participated in this sub-study. The patients were acute admissions >= 80 years of age and frailty was assessed at admission by two independent observers using the CFS. Information was obtained from the patient, if not feasible, from the family/caregivers or from hospital files. The profession of the rater and source of data were recorded along with the score. Interrater variability was calculated using linear weighted kappa analysis. Results 1923 pairs of assessors were included and background data of patients were similar to the whole cohort (n = 3920). We found a very high inter-rater agreement (weighted kappa 0.86), also in subgroup analyses. The agreement when comparing information from family or hospital records was better than using only direct patient information, and pairs of raters from same profession performed better than from different professions. Conclusions Overall, we documented a high reliability using CFS in this setting. This frailty score could be used more frequently in elderly ICU patients in order to create a more holistic and realistic impression of the patient s condition prior to ICU admission.

Place, publisher, year, edition, pages
Springer, 2021
Keywords
Clinical frailty scale; Inter-rater variability; Intensive care; Octogenarians
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:liu:diva-173624 (URN)10.1186/s13613-021-00815-7 (DOI)000614405200001 ()33534010 (PubMedID)2-s2.0-85100451283 (Scopus ID)
Note

Funding Agencies|Western Health region in Norway

Available from: 2021-02-26 Created: 2021-02-26 Last updated: 2021-10-04Bibliographically approved
Wilhelms, S., Walther, S. M., Sjöberg, F. & de Geer, L. (2020). Causes of late mortality among ICU-treated patients with sepsis. Acta Anaesthesiologica Scandinavica, 64(7), 961-966
Open this publication in new window or tab >>Causes of late mortality among ICU-treated patients with sepsis
2020 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 64, no 7, p. 961-966Article in journal (Refereed) Published
Abstract [en]

Background Patients with sepsis may have an increased risk of late mortality, but the causes of late death are unclear. This retrospective matched cohort study aimed to determine the causes of late death (>= 1 year) among patients with sepsis compared to patients without sepsis. Methods 8760 patients with severe sepsis or septic shock (2001 consensus criteria) registered in the Swedish Intensive Care Registry (2008-2013) were compared with a 1:1 matched (gender, age, SAPS3 probability for death, ICU length of stay) control group consisting of non-septic ICU patients. Causes of death (International Classification of Diseases codes) were obtained from the Swedish Cause of Death Register (2008-2014). Results During 2008-2014, 903 patients with sepsis died at >= 365 days after their initial septic event, compared to 884 patients in the control group. Median time of follow-up was 313 days (sepsis group, interquartile range 11-838 days) vs 288 days (control group, 9-836 days). The most common causes of death were heart diseases (sepsis: 50.2%, non-septic: 48.6%) and cancer (sepsis: 33.7%, non-septic: 31.7%). Infectious diseases were significantly more common cause of death in the sepsis group (24.3% vs 19.6%, respectively; P < .05). Pneumonia was a common infectious cause of death in both groups, whereas sepsis was more common in the sepsis group. Conclusions The most common causes of late death after ICU admission among patients with and without sepsis were heart diseases and cancer. However, patients with sepsis more frequently had infectious diseases as a cause of late death, compared to non-septic patients.

Place, publisher, year, edition, pages
WILEY, 2020
Keywords
epidemiology; late mortality; sepsis
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-165569 (URN)10.1111/aas.13592 (DOI)000527384900001 ()32319686 (PubMedID)
Note

Funding Agencies|Region Ostergotland

Available from: 2020-05-06 Created: 2020-05-06 Last updated: 2021-10-04
Martensson, J., Engerström, L., Walther, S. M., Grip, J., Berggren, R. K. & Larsson, E. (2020). COVID-19 critical illness in Sweden: characteristics and outcomes at a national population level. Critical Care and Resuscitation, 22(4), 312-320
Open this publication in new window or tab >>COVID-19 critical illness in Sweden: characteristics and outcomes at a national population level
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2020 (English)In: Critical Care and Resuscitation, ISSN 1441-2772, Vol. 22, no 4, p. 312-320Article in journal (Refereed) Published
Abstract [en]

Objective: During the coronavirus disease 2019 (COVID-19) pandemic, baseline demographics and comorbidities of patients with COVID-19 have been presented, but there are limited data on outcomes of severely ill patients. We aimed to examine the association between patient characteristics and 30-day mortality among patients with COVID-19 treated in the intensive care unit (ICU). Design: Population-based cohort study. Setting: ICUs in Sweden. Participants: All consecutive patients with COVID-19 admitted to Swedish ICUs from 6 March to 5 April 2020. Main outcome measures: The primary outcome was 30-day mortality after ICU admission. Patient demographics, comorbidities and clinical characteristics were also retrieved. Results: A total of 604 patients were included. The median age was 61 years (interquartile range [IQR], 52-70 years) and 458 patients (76%) were males. The most common comorbidities were hypertension (35.9%) and diabetes (25.7%), whereas 36.4% of patients had no comorbidities. Median Simplified Acute Physiology Score (SAPS) 3 was 53 (IQR, 46-60). Of 573 patients with available respiratory support data, 487 (85.0%) received invasive mechanical ventilation. Among 518 patients with available data, 117 (22.6%) received renal replacement therapy. Median length of stay was 13 days (IQR, 6-20 days). Mortality at 30 days was 32.6%. In the multivariable Cox regression model, age (hazard ratio [HR] 1.06; 95% CI, 1.04-1.07 per year), the presence of one or more comorbidities (HR, 1.80; 95% CI, 1.20-2.68), chronic obstructive pulmonary disease or asthma (HR, 1.68; 95% CI, 1.12-2.50), hypertension (HR, 1.41; 95% CI, 1.01-1.99), and acute illness severity (SAPS 3 excluding age and comorbidity) (HR, 1.06; 95% CI, 1.04-1.09) were associated with 30-day mortality. Conclusions: This population-based cohort study presents 30-day mortality of 604 ICU patients with COVID-19. The higher mortality was explained by older age, the presence chronic illness, and acute illness severity.

Place, publisher, year, edition, pages
Strawberry Hills, NSW, Australia: AUSTRALASIAN MED PUBL CO LTD, 2020
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:liu:diva-173511 (URN)000612535900005 ()
Note

Funding Agencies|Knut and Alice Wallenberg FoundationKnut & Alice Wallenberg Foundation

Available from: 2021-02-22 Created: 2021-02-22 Last updated: 2021-10-04Bibliographically approved
Strandberg, G., Walther, S. M., Agvald Ohman, C. & Lipcsey, M. (2020). Mortality after Severe Sepsis and Septic Shock in Swedish Intensive Care Units 2008-2016-A nationwide observational study. Acta Anaesthesiologica Scandinavica, 64(7), 967-975
Open this publication in new window or tab >>Mortality after Severe Sepsis and Septic Shock in Swedish Intensive Care Units 2008-2016-A nationwide observational study
2020 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 64, no 7, p. 967-975Article in journal (Refereed) Published
Abstract [en]

Background Recent studies have reported substantially decreased hospital mortality for sepsis, but data are scarcer on outcomes after hospital discharge. We studied mortality up to 1 year in Swedish intensive care unit (ICU) patients with and without sepsis. Methods Demographic and medical data for all registered adult general ICU patients admitted between 01-01-2008 and 30-09-2016 were retrieved from the Swedish Intensive Care Registry and linked with the National Patient Register for comorbidity data and the Cause of Death Register for death dates. The population was divided in two cohorts; (a) Patients with a diagnosis of severe sepsis or septic shock and (b) All other ICU patients. Crude yearly mortality was calculated, and logistic regression was used to analyse predictors of mortality. Results 28 886 sepsis and 221 941 nonsepsis ICU patients were identified. In the sepsis cohort, in 2008 unadjusted mortality was 32.6% at hospital discharge, 32.7% at 30 days, 39% at 90 days and 46.8% at 365 days. In 2016, mortality was 30.5% at hospital discharge, 31.9% at 30 days and 38% at 90 days. Mortality at 365 days was 45.3% in 2015. Corresponding nonsepsis mortality was 15.4%, 16.2%, 20% and 26% in 2008 and 15.6%, 17.1%, 20.7% and 26.7% in 2016/2015. No consistent decrease in odds of mortality was seen in the adjusted analysis. Conclusions Mortality in severe sepsis and septic shock is high, with more than one in three patients not surviving three months after ICU admission, and adjusted mortality has not decreased convincingly in Sweden 2008-2016.

Place, publisher, year, edition, pages
WILEY, 2020
Keywords
adult; comorbidity; critical care; epidemiology; mortality; sepsis
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-165563 (URN)10.1111/aas.13587 (DOI)000528631400001 ()32232853 (PubMedID)
Available from: 2020-05-06 Created: 2020-05-06 Last updated: 2021-10-04
Guidet, B., de Lange, D. W., Boumendil, A., Leaver, S., Watson, X., Boulanger, C., . . . Flaatten, H. (2020). The contribution of frailty, cognition, activity of daily life and comorbidities on outcome in acutely admitted patients over 80 years in European ICUs: the VIP2 study. Intensive Care Medicine, 46, 57-69
Open this publication in new window or tab >>The contribution of frailty, cognition, activity of daily life and comorbidities on outcome in acutely admitted patients over 80 years in European ICUs: the VIP2 study
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2020 (English)In: Intensive Care Medicine, ISSN 0342-4642, E-ISSN 1432-1238, Vol. 46, p. 57-69Article in journal (Refereed) Published
Abstract [en]

Purpose Premorbid conditions affect prognosis of acutely-ill aged patients. Several lines of evidence suggest geriatric syndromes need to be assessed but little is known on their relative effect on the 30-day survival after ICU admission. The primary aim of this study was to describe the prevalence of frailty, cognition decline and activity of daily life in addition to the presence of comorbidity and polypharmacy and to assess their influence on 30-day survival. Methods Prospective cohort study with 242 ICUs from 22 countries. Patients 80 years or above acutely admitted over a six months period to an ICU between May 2018 and May 2019 were included. In addition to common patients characteristics and disease severity, we collected information on specific geriatric syndromes as potential predictive factors for 30-day survival, frailty (Clinical Frailty scale) with a CFS amp;gt; 4 defining frail patients, cognitive impairment (informant questionnaire on cognitive decline in the elderly (IQCODE) with IQCODE amp;gt;= 3.5 defining cognitive decline, and disability (measured the activity of daily life with the Katz index) with ADL amp;lt;= 4 defining disability. A Principal Component Analysis to identify co-linearity between geriatric syndromes was performed and from this a multivariable model was built with all geriatric information or only one: CFS, IQCODE or ADL. Akaikes information criterion across imputations was used to evaluate the goodness of fit of our models. Results We included 3920 patients with a median age of 84 years (IQR: 81-87), 53.3% males). 80% received at least one organ support. The median ICU length of stay was 3.88 days (IQR: 1.83-8). The ICU and 30-day survival were 72.5% and 61.2% respectively. The geriatric conditions were median (IQR): CFS: 4 (3-6); IQCODE: 3.19 (3-3.69); ADL: 6 (4-6); Comorbidity and Polypharmacy score (CPS): 10 (7-14). CFS, ADL and IQCODE were closely correlated. The multivariable analysis identified predictors of 1-month mortality (HR; 95% CI): Age (per 1 year increase): 1.02 (1.-1.03, p = 0.01), ICU admission diagnosis, sequential organ failure assessment score (SOFA) (per point): 1.15 (1.14-1.17, p amp;lt; 0.0001) and CFS (per point): 1.1 (1.05-1.15, p amp;lt; 0.001). CFS remained an independent factor after inclusion of life-sustaining treatment limitation in the model. Conclusion We confirm that frailty assessment using the CFS is able to predict short-term mortality in elderly patients admitted to ICU. Other geriatric syndromes do not add improvement to the prediction model. Since CFS is easy to measure, it should be routinely collected for all elderly ICU patients in particular in connection to advance care plans, and should be used in decision making.

Place, publisher, year, edition, pages
SPRINGER, 2020
Keywords
Critical care; Outcome; Prediction; Elderly; Frailty; Cognitive functioning; Activities of daily living; Comorbidity
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-162744 (URN)10.1007/s00134-019-05853-1 (DOI)000499414900002 ()31784798 (PubMedID)
Note

Funding Agencies|Western Health region in Norway; dep. of Epidemiology, University of Aarhus, Denmark

Available from: 2019-12-18 Created: 2019-12-18 Last updated: 2021-10-04
Larsson Viksten, J., Engerström, L., Steinvall, I., Samuelsson, A., Fredrikson, M., Walther, S. & Sjöberg, F. (2019). Children aged 0-16 admitted to Swedish intensive care units and paediatric intensive care units showed low mortality rates.. Acta Paediatrica, 108(8), 1460-1466
Open this publication in new window or tab >>Children aged 0-16 admitted to Swedish intensive care units and paediatric intensive care units showed low mortality rates.
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2019 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 8, p. 1460-1466Article in journal (Refereed) Published
Abstract [en]

AIM: This study described the basic characteristics of children aged 0-16 years who were treated in intensive care units (ICUs) and paediatric ICUs (PICUs), compared their outcomes and examined any causes of death.

METHODS: This was a retrospective cohort study of admissions to 74 ICUs and three PICUs in Sweden that were recorded in the Swedish Intensive Care Registry from January 1, 2008 to December 31, 2012.

RESULTS: We retrieved data on 12 756 children who were admitted 17 003 times. The case mix differed between the ICUs, which were mainly admissions for injuries, accidents and observation, and PICUs, which were mainly admissions for malformations, genetic abnormalities and respiratory problems (p < 0.001). The median stays in the ICUs and PICUs were 1.4 and 3.5 days (p < 0.001), respectively. The respective crude mortality rates were 1.1% and 2.0, and the Paediatric Index of Mortality version 2 standardised mortality ratios were 0.43 and 0.50. None of these differences were significant. Most deaths were within 24 hours: About 57% in the ICUs, mainly from brain anomalies, and 13% in the PICUs, mainly from circulatory problems.

CONCLUSION: Sweden had a low mortality rate in both ICUs and PICUs and the children admitted to these two types of unit differed.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2019
Keywords
Child mortality, Demographics, Intensive care unit, Length of stay, Paediatric intensive care unit
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:liu:diva-154075 (URN)10.1111/apa.14708 (DOI)000474935600016 ()30582755 (PubMedID)
Funder
Region Östergötland
Note

Funding agencies: Region Ostergotland and Linkoping University

Available from: 2019-01-29 Created: 2019-01-29 Last updated: 2021-12-28
Parenmark, F. & Walther, S. (2019). Increased risk of dying if discharged with inter-hospital transfer due to lack of ICU beds. A nationwide study from the Swedish Intensive Care Registry. Paper presented at ESICMs LIVES 2019, Berlin 28 September-2 October. Intensive Care Medicine Experimental, 7(Supplement 3), 634-634, Article ID 000228.
Open this publication in new window or tab >>Increased risk of dying if discharged with inter-hospital transfer due to lack of ICU beds. A nationwide study from the Swedish Intensive Care Registry
2019 (English)In: Intensive Care Medicine Experimental, E-ISSN 2197-425X, Vol. 7, no Supplement 3, p. 634-634, article id 000228Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

INTRODUCTION. Most patients admitted to intensive care are discharged to a general ward in the same hospital, but some patients require transfer to another hospital. Indications for interhospital transfers (IHT) include referral for specialist treatment, lack of intensive care beds at the referring ICU and repatriation to ICU in home hospital [1].

OBJECTIVES. To review mortality of ICU-patients undergoing IHT and analyse whether different indications for transfer render different mortalities.

METHODS. Retrospective cohort register study using the Swedish Intensive Care Registry (SIR) during 2016-2018. The SIR collects data from 98.8% of Swedish ICUs including data on discharge from ICUs to other hospitals/ICUs. Transfers were divided into three categories: transfer due to medical reasons, lack of ICU beds or repatriation to ICU in home hospital. We analysed odds ratios (ORs) for dying within 30 days after discharge from ICU using risk adjusted (SAPS3 score) multi-level mixed effect logistic regression with ICUs as random effect.

RESULTS. We identified 12,356 patients who were discharged to another ICU and hospital, i.e. inter-hospital transfers. The unadjusted mortality 30 days after IHT was 17.2 % compared to 12.4 % if discharged to ward in the same hospital. Mortality after IHT varied with the cause of discharge (Figure).Main diagnoses for transfer due to specialist treatment were subarachnoid haemorrhage, head injury and multi-trauma whilst for lack of ICU beds post cardiac arrest, respiratory failure and pneumonia dominated. Risk adjusted analysis showed a significantly increased risk of dying after discharge due to lack of ICU-beds in comparison with other reasons for IHTs

CONCLUSION. The adjusted risk of dying within 30 days after interhospital transfer was greater among critically ill patients when the transfer was due to lack of beds in the referring ICU. The increased mortality lingered for at least 6 months underlining the importance to identify causes and intervene to avoid unnecessary loss of life.

Place, publisher, year, edition, pages
Springer, 2019
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:liu:diva-163276 (URN)10.1186/s40635-019-0265-y (DOI)
Conference
ESICMs LIVES 2019, Berlin 28 September-2 October
Available from: 2020-01-23 Created: 2020-01-23 Last updated: 2021-10-04Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-3862-2556

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