Journal article
Longer Total Interhospital Transfer Times for Rural Sepsis Patients Not Associated with Increased Mortality
Prehospital emergency care, Vol.29(8), pp.1111-1116
11/17/2025
DOI: 10.1080/10903127.2024.2447044
PMID: 39786720
Abstract
Sepsis is a time-sensitive condition, and many rural emergency department (ED) sepsis patients are transferred to tertiary hospitals. The objective of this study was to determine whether longer transport times during interhospital transfer are associated with higher sepsis mortality or increased hospital length-of-stay (LOS).
A cohort of rural adult (age ≥ 18y) sepsis patients transferred between hospitals were identified in the TELEmedicine as a Virtual Intervention for Sepsis Care in Emergency Departments (TELEVISED) parent study. We collected data on the time spent between triage and disposition at the rural ED (ED LOS), time from rural ED disposition to arrival at the destination hospital (transport duration), and overall time from rural ED triage to arrival at the destination hospital (total transfer time). We used a zero inflated negative binomial model with log link for the primary outcome (28-day hospital-free days), and a logit model for secondary outcomes of Surviving Sepsis Campaign (SSC) bundle adherence and in-hospital mortality. We included clinical and demographic covariates in model development.
We included 359 transferred rural sepsis patients. There was no association between ED LOS (aRR: 1.00; 95% CI: 0.98-1.02), transport duration (aRR: 1.03; 95% CI: 0.99-1.07), or total transfer time (aRR: 1.01; 95% CI: 0.99-1.03) and 28-day hospital free days. Similarly, we found no association between ED LOS, transport duration, and total transfer time with secondary outcomes.
Longer total transfer time showed no association with 28-day hospital free days in rural sepsis patients. Future work will seek to better understand how rural ED sepsis care can be optimized to maximize outcomes in transferred patients.
Details
- Title: Subtitle
- Longer Total Interhospital Transfer Times for Rural Sepsis Patients Not Associated with Increased Mortality
- Creators
- Benjamin Wilkinson - Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USAEliezer Santos León - University of IowaJ Priyanka Vakkalanka - University of IowaAzeemuddin Ahmed - University of IowaKarisa K Harland - University of IowaBrian M Fuller - Washington University in St. Louis School of MedicineKalyn Campbell - University of MinnesotaMorgan B Swanson - Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USABrett Faine - University of IowaAnne Zepeski - University of IowaLuke Mack - Sanford HealthAmanda Bell - Avera eCARE, Sioux Falls, SD, USAKatie DeJong - Avera eCARE, Sioux Falls, SD, USAKelli Wallace - University of IowaEdith A Parker - University of IowaKeith Mueller - University of IowaElizabeth Chrischilles - University of IowaChristopher R Carpenter - Mayo ClinicMichael P Jones - University of IowaSteven Q Simpson - University of KansasNicholas M Mohr - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Prehospital emergency care, Vol.29(8), pp.1111-1116
- DOI
- 10.1080/10903127.2024.2447044
- PMID
- 39786720
- NLM abbreviation
- Prehosp Emerg Care
- ISSN
- 1545-0066
- eISSN
- 1545-0066
- Publisher
- TAYLOR & FRANCIS INC
- Grant note
- Agency for Healthcare Research and Quality [AHRQ]: K08 HS025753 Rural Telehealth Research Center - Office for the Advancement of Telehealth, Health Resources and Services Administration [HRSA]: U3GRH40003
This work was supported by a grant from the Agency for Healthcare Research and Quality [AHRQ, K08 HS025753]. Dr. Mohr is addition-ally supported by funding from the Rural Telehealth Research Center, which is supported by the Office for the Advancement of Telehealth, Health Resources and Services Administration [HRSA, U3GRH40003]. The views expressed in this publication are solely those of the authors and do not reflect the official views of AHRQ, HRSA, or the U.S. Government.
- Language
- English
- Electronic publication date
- 01/09/2025
- Date published
- 11/17/2025
- Academic Unit
- Pharmacy; Public Health Administration; Health Management and Policy; Biostatistics; Pharmacy Practice and Science; Center for Social Science Innovation; Anesthesia; Injury Prevention Research Center; Statistics and Actuarial Science; Epidemiology; Emergency Medicine; Community and Behavioral Health; Law Faculty
- Record Identifier
- 9984771664402771
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