Characteristic of the Death at First 24 Hours in Referral Patients from Rural Hospital: a Study of Provincial Data Analysis

Abstract

Background: Referral system is an organization that transfers patients from the rural hospitals to the higher capability medical centers. According to safety concerns during transportation, several types of monitoring equipment are used and signs of clinical deterioration are observed and treated by health care personnel. However, adverse events affecting clinical worsened still occurred and leads to the death.Objective: This study aimed to evaluate the 24-hour (24-hr) death rate after referred, and to compare the characteristic between death and survival patient within 24-hr after refer from rural hospital to Khon Kaen hospital.Method: This was a retrospective cohort study, enrolled ESI level 1 patients transferred from the rural hospitals to Khon Kaen hospital from 1st October 2018 to 30th September 2019. The outcomes were the death rate and characteristics of patients who died within 24-hr after transferred.Result: Of the 3,750 critically patients included in this study, the average ± SD age was 61.8±16.6 years; 2,390 (63.7%) were male, 3,333(88.9%) were non-trauma patients, and 3,457(92.2%) were intubated patients. The death rate within 24-hr after transferred patients was 25.3%. Age of 60-79 years, intubated patients, used ventilator, and systolic BP <90mmHg groups were significantly different (p-value < 0.05), the death within 24-hr group was higher than the compared group.Conclusion: One-fourth of ESI level 1 patients developed death within 24-hr. The methods to improve equality of inter-hospital transfer and factors affecting the death outcomes should be evaluated.