The impact of inter-hospital transfer on outcomes in lower gastrointestinal bleeding: a retrospective cohort analysis

Authors

Ali Jaan, Rochester Regional HealthFollow
Zouina Sarfraz, Department of Medicine, Fatima Jinnah Medical University, Queen's Road, Mozang Chungi, Lahore, 54000, Pakistan.
Adeena Maryyum, Department of Medicine, Ayub Medical College, Abbottabad, Pakistan.
Umer Farooq, Department of Gastroenterology, Saint Louis University, St. Louis, MO, USA.
Muhammad Farhan Ashraf, Rochester Regional HealthFollow
Fatima Warraich, Rochester Regional HealthFollow
Mark S. Mcfarland, Rochester Regional HealthFollow
Jason Gutman, Rochester Regional HealthFollow
Karin Dunnigan, Rochester Regional HealthFollow

Department

Internal Medicine

Additional Department

Gastroenterology

Document Type

Article

Publication Title

BMC Gastroenterology

Abstract

Background: This study investigates the role of interhospital transfer (IHT) in lower gastrointestinal bleeding (LGIB) management and its impact on patient outcomes, focusing on mortality rates, complication occurrences, procedural performance, and resource utilization in patients diagnosed with LGIB.

Methods: This retrospective cohort study used data from the National Inpatient Sample database from 2017 to 2020. It included adult patients diagnosed with LGIB, assessing the impact of IHT on outcomes such as mortality, complication rates, procedural performance, and resource utilization. Adjusted odds ratios (AOR) and adjusted mean differences (AMD) were used to evaluate these impacts.

Results: A total of 393,495 LGIB patients were analyzed, with 31,565 (8.02%) undergoing interhospital transfer. Transferred patients exhibited significantly higher inpatient mortality (AOR 1.96, P < 0.01). They also faced increased risks of acute kidney injury (AOR 1.32, P < 0.01), septic shock (AOR 2.11, P < 0.01), and intensive care unit admission (AOR: 2.61, P < 0.01). These patients were more likely to undergo interventional radiology-guided embolization (AOR 2.68, P < 0.01) and showed variations in colonoscopy procedures. Resource utilization was also higher among transferred patients, with an increased mean length of hospital stay by 4.37 days (P < 0.01) and higher hospitalization charges (mean difference $61,239, P < 0.01).

Conclusion: Interhospital transfer in LGIB patients is associated with increased mortality, greater resource utilization, and the need for more specialized procedural interventions. Enhanced clinical vigilance and tailored resource allocation for transferred LGIB patients are necessary. Future research should optimize care strategies for these high-risk patients.

First Page

183

DOI

10.1186/s12876-025-03755-9

Volume

25

Issue

1

Publication Date

3-18-2025

Medical Subject Headings

Humans; Patient Transfer (statistics & numerical data); Retrospective Studies; Gastrointestinal Hemorrhage (therapy, mortality); Male; Female; Middle Aged; Aged; Hospital Mortality; Adult; United States (epidemiology); Embolization, Therapeutic (statistics & numerical data); Length of Stay (statistics & numerical data); Treatment Outcome; Acute Kidney Injury (therapy, mortality); Shock, Septic (therapy, mortality)

PubMed ID

40102773

Recommended Citation

Jaan, A., Sarfraz, Z., Maryyum, A., Farooq, U., Ashraf, M. F., Warraich, F., Mcfarland, M. S., Gutman, J., & Dunnigan, K. (2025). The impact of inter-hospital transfer on outcomes in lower gastrointestinal bleeding: a retrospective cohort analysis. BMC Gastroenterology, 25 (1), 183. https://doi.org/10.1186/s12876-025-03755-9