Impact of hospital transfer to hubs on outcomes of cardiogenic shock in the real world
Autor: | Daniel Y Lu, Reema Bhatt, Udhay Krishnan, Ilhwan Yeo, Jim W. Cheung, Parag Goyal, Danielle Olonoff, Evelyn M. Horn, Supria Batra, Dmitriy N. Feldman, Luke K. Kim, Maria G. Karas, Kevin Chan, Andrew Adelsheimer, Christopher Sciria, Irina Sobol |
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Rok vydání: | 2021 |
Předmět: |
Right heart catheterization
Heart Failure medicine.medical_specialty business.industry Cardiogenic shock Shock Cardiogenic Odds ratio 030204 cardiovascular system & hematology medicine.disease Triage Confidence interval Hospitals 03 medical and health sciences 0302 clinical medicine Transfer (computing) Emergency medicine Medicine Humans Hospital Mortality Cardiology and Cardiovascular Medicine business Lower mortality Retrospective Studies |
Zdroj: | European journal of heart failureReferences. 23(11) |
ISSN: | 1879-0844 |
Popis: | AIMS Cardiogenic shock (CS) is associated with significant mortality, and there is a movement towards regional 'hub-and-spoke' triage systems to coordinate care and resources. Limited data exist on outcomes of patients treated at CS transfer hubs. METHODS AND RESULTS Cardiogenic shock hospitalizations were obtained from the Nationwide Readmissions Database 2010-2014. Centres receiving any interhospital transfers with CS in a given year were classified as CS transfer 'hubs'; those without transfers were classified as 'spokes.' In-hospital mortality was compared among three cohorts: (A) direct admissions to spokes, (B) direct admissions to hubs, and (C) interhospital transfer to hubs. Among hospitals treating CS, 70.6% were classified as spokes and 29.4% as hubs. A total of 130 656 (31.7%) hospitalizations with CS were direct admission to spokes, 253 234 (61.4%) were direct admissions to hubs, and 28 777 (7.0%) were transfer to hubs. CS mortality was 47.8% at spoke hospitals and was lower at hub hospitals, both for directly admitted (39.3%, P |
Databáze: | OpenAIRE |
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