International Journal of Colorectal Disease

, Volume 28, Issue 2, pp 273–276 | Cite as

Transfer status is a risk factor for increased in-hospital mortality in patients with diverticular hemorrhage

  • Haisar E. Dao
  • Peter E. Miller
  • Justin H. Lee
  • Reza Kermani
  • Alan W. Hackford
Original Article

Abstract

Purpose

Gastrointestinal tract hemorrhage is a common problem accounting for approximately 1 % of hospital admissions. It is estimated that one third of the episodes of lower gastrointestinal hemorrhage are secondary to diverticular disease. Inter-institutional transfer has been associated with delay in care and increased in-hospital mortality. We hypothesized that patients with diverticular hemorrhage that were transferred from an acute care hospital to tertiary care institutions have increased in-hospital morbidity and mortality when compared to primarily admitted patients.

Materials and methods

We performed a retrospective analysis of the Nationwide Inpatient Sample for the year 2008. Patients with a primary discharge diagnosis of diverticular hemorrhage were selected. Multivariate logistic regression was used to identify the relationship between transfer status and in-hospital mortality.

Results

A total of 99,415 hospitalizations for diverticular hemorrhage were identified. Transferred patients had higher in-hospital mortality rates compared to primarily admitted patients (3.5 vs. 1.8 %, p < 0.001), as well as increased length of stay (8.4 vs. 5.4 days, p < 0.001) and a higher rate of total abdominal colectomy (1.2 vs. 0.6 %, p < 0.001). Multivariate analysis indicated that transfer status was associated with increased in-hospital mortality [OR 1.8, 95 % CI 1.5–2.8, p < 0.001].

Conclusions

Inter-institutional transfer for diverticular bleeding is associated with increased in-hospital mortality, increased total abdominal colectomy rate, as well as increased economic burden including mean length of stay and total hospital charges. Further prospective studies are needed to analyze the clinical information of patients requiring transfer to another hospital in order to identify those patients who would truly benefit from inter-institutional transfer.

Keywords

Diverticular hemorrhage Transfer status Mortality Total abdominal colectomy 

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Haisar E. Dao
    • 1
  • Peter E. Miller
    • 1
  • Justin H. Lee
    • 1
  • Reza Kermani
    • 1
  • Alan W. Hackford
    • 1
  1. 1.Department of Surgery, Division of Colorectal Surgery, CMP 2S, Steward St. Elizabeth’s Medical CenterTufts University School of MedicineBostonUSA

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