Only 1 in 5 patients meeting American College of Surgeons' transfer criteria undergo transfer: 4 insights

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.

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