Not all patients who meet the American College of Surgeons' criteria for transfer are transferred from nontertiary centers to facilities providing higher-level care, according to a study published in JAMA Surgery.
Researchers investigated National Trauma Data Bank data involving 96,528 patients taken to nontertiary centers that met ACS guideline transfer criteria.
Here are four insights:
1. Among the 96,528 patients, only 20.1 percent underwent a transfer.
2. Patient-level factors associated with nontransfer included:
• Age older than 65 years
• Severe chest injury
• Commercial insurance
3. Center-level factors associated with nontransfer included:
• Larger bed size
• Nontrauma center (versus level III centers)
• University affiliation
• More trauma surgeons
• More neurosurgeons
4. Overall, patient-level factors accounted for 36 percent and center-level factors accounted for 58 percent of the variation in transfer practices.