2024 Critical Care Congress Skip to main content
2024 Critical Care Congress Main banner
Back

Research Snapshot Theater: Quality and Patient Safety/Resuscitation, Adult

(1303) The Critical Care Resuscitation Unit’s Impacts on Outcome of Patients From Rural Hospitals

Tuesday, January 23, 2024
10:00 AM – 11:00 AM MT
Location: Connections Central - RST 13
Introduction: Patients who presented to rural hospitals with time sensitive diseases frequently have delayed interventions and poorer outcomes. The Critical Care Resuscitation Unit (CCRU) at the University of Maryland was created to expedite patients with high disease acuity or requiring time-sensitive interventions. We hypothesized patients being transferred to the CCRU from rural hospitals would receive similar and outcomes as patients transferred from urban hospitals.

Methods: This was a retrospective study of adult patients who were transferred to the CCRU in 2018. Rural areas were identified according to the state of Maryland’s designation. Outcomes were time to bed assignments, to arrival at the CCRU, the number of patients going for urgent surgical interventions within 12 hours of arrival and hospital mortality. We used multivariable logistic regression to measure association of independent variables, rurality with mortality.

Results: We analyzed at total of 1381 patients, 484 (35%) were transferred from rural hospitals. Rural patients had same means of age (58 vs 57 years, P = 0.75), SOFA scores (3.9 vs. 4.1, P = 0.35), but were transferred from longer distance (94 km vs. 33 km, P < 0.001). Mean time from transfer request (in minute) to CCRU bed assignment, CCRU arrival for rural patients was 136 (+/- 472), 314 (+/- 438) and 146 (+/- 478), 289 (+/- 490) for urban patients (P > 0.05 for both). Rates of urgent operation and mortality for rural patients were 123 (25%), 70 (14%) vs. 205 (23%), 144 (16%) for urban patients, respectively. High SOFA score (OR 1.2, 95% CI 1.14-1.28) but not transferring from rural areas (OR 0.9, 95% CI 0.6-1.39) were associated with in-hospital.

Conclusions: The CCRU provided patients from rural areas with quick transfer, and similar rates of urgent surgical intervention. Patients who were transferred to the CCRU from rural hospitals were not associated with increased odds of in-hospital death.