liu.seSearch for publications in DiVA
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Influence of income and education on outcomes of intensive care in a healthcare system with full universal health insurance - a nationwide analysis of individual-level data
Region Östergötland, Heart and Medicine Center, Department of Thoracic and Vascular Surgery. Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Linköping (ANOPIVA). Linköping University, Department of Medical and Health Sciences, Division of Nursing Science.
Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Linköping (ANOPIVA). Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology.ORCID iD: 0000-0002-5903-2918
2019 (English)In: Intensive Care Medicine Experimental, ISSN 1646-2335, E-ISSN 2197-425X, Vol. 7, no Supplement 3, article id 000224Article 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
Santarem, Portugal: Escola Superior de Educacao de Santarem , 2019. Vol. 7, no Supplement 3, article id 000224
National Category
Anesthesiology and Intensive Care
Identifiers
URN: urn:nbn:se:liu:diva-163277OAI: oai:DiVA.org:liu-163277DiVA, id: diva2:1388132
Conference
ESICMs LIVES 2019, Berlin 28 September-2 October
Available from: 2020-01-23 Created: 2020-01-23 Last updated: 2020-02-03Bibliographically approved

Open Access in DiVA

No full text in DiVA

Authority records BETA

Walther, StenOrwelius, LottiSjöberg, Folke

Search in DiVA

By author/editor
Walther, StenOrwelius, LottiKristensson, M.Sjöberg, Folke
By organisation
Department of Thoracic and Vascular SurgeryDivision of Cardiovascular MedicineFaculty of Medicine and Health SciencesDepartment of Anaesthesiology and Intensive Care in Linköping (ANOPIVA)Division of Nursing ScienceDepartment of Medical and Health SciencesDepartment of Hand and Plastic SurgeryDivision of Surgery, Orthopedics and Oncology
In the same journal
Intensive Care Medicine Experimental
Anesthesiology and Intensive Care

Search outside of DiVA

GoogleGoogle Scholar

urn-nbn

Altmetric score

urn-nbn
Total: 31 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf