Factors influencing interhospital transfer delays in emergency general surgery: a systematic review and narrative synthesis
Background Emergency general surgery is an emerging public health issue globally, with substantial healthcare burden. Interhospital transfer of critically unwell surgical patients has been the mainstay of bridging gaps in surgical coverage in regional and rural locations, despite evidence of greater...
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Published in | ANZ journal of surgery Vol. 92; no. 6; pp. 1314 - 1321 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
Melbourne
John Wiley & Sons Australia, Ltd
01.06.2022
Blackwell Publishing Ltd |
Subjects | |
Online Access | Get full text |
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Abstract | Background
Emergency general surgery is an emerging public health issue globally, with substantial healthcare burden. Interhospital transfer of critically unwell surgical patients has been the mainstay of bridging gaps in surgical coverage in regional and rural locations, despite evidence of greater morbidity and mortality. Delays in transfer invariably occurs and compounds the situation. Our aim was to examine the factors influencing interhospital transfer delays in emergency general surgical patients.
Methods
A systematic search of PubMED and EmBase, was performed by two researchers from 2020 to 23rd Feb 2021, for English articles related to interhospital transfer delays in emergency general surgical patients, with an age of >16. Articles were critically appraised and data were extracted into a pre‐specified data extraction form. No data was suitable for statistical analysis and a narrative synthesis was performed instead.
Results
Six relevant articles were identified from the search. All studies were retrospective cohort studies with moderate to high risk of bias. Lack of consultant surgeon input, after hours transfer, need for intensive care bed and poor transfer documentation may have a role in interhospital transfer delays. Patients with public health insurance, multiple comorbidities and non‐emergency medical conditions experience longer transfer request time and may be at risk of precipitating interhospital transfer delays. Transfer delays are seen in transfers over longer distances.
Conclusion
There is a paucity of knowledge on what and how factors influence interhospital transfer delays in emergency general surgical patients. Well‐designed prospective cohort studies are required to bridge this knowledge gap.
Gaps in emergency surgical coverage in regional and rural locations are managed with interhospital transfers, despite inferior outcomes. A systematic review of the contemporary literature was performed and identified a paucity of knowledge on factors influencing interhospital transfer delays. More robust prospective cohort studies were recommended. |
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AbstractList | BackgroundEmergency general surgery is an emerging public health issue globally, with substantial healthcare burden. Interhospital transfer of critically unwell surgical patients has been the mainstay of bridging gaps in surgical coverage in regional and rural locations, despite evidence of greater morbidity and mortality. Delays in transfer invariably occurs and compounds the situation. Our aim was to examine the factors influencing interhospital transfer delays in emergency general surgical patients.MethodsA systematic search of PubMED and EmBase, was performed by two researchers from 2020 to 23rd Feb 2021, for English articles related to interhospital transfer delays in emergency general surgical patients, with an age of >16. Articles were critically appraised and data were extracted into a pre‐specified data extraction form. No data was suitable for statistical analysis and a narrative synthesis was performed instead.ResultsSix relevant articles were identified from the search. All studies were retrospective cohort studies with moderate to high risk of bias. Lack of consultant surgeon input, after hours transfer, need for intensive care bed and poor transfer documentation may have a role in interhospital transfer delays. Patients with public health insurance, multiple comorbidities and non‐emergency medical conditions experience longer transfer request time and may be at risk of precipitating interhospital transfer delays. Transfer delays are seen in transfers over longer distances.ConclusionThere is a paucity of knowledge on what and how factors influence interhospital transfer delays in emergency general surgical patients. Well‐designed prospective cohort studies are required to bridge this knowledge gap. Emergency general surgery is an emerging public health issue globally, with substantial healthcare burden. Interhospital transfer of critically unwell surgical patients has been the mainstay of bridging gaps in surgical coverage in regional and rural locations, despite evidence of greater morbidity and mortality. Delays in transfer invariably occurs and compounds the situation. Our aim was to examine the factors influencing interhospital transfer delays in emergency general surgical patients. A systematic search of PubMED and EmBase, was performed by two researchers from 2020 to 23rd Feb 2021, for English articles related to interhospital transfer delays in emergency general surgical patients, with an age of >16. Articles were critically appraised and data were extracted into a pre-specified data extraction form. No data was suitable for statistical analysis and a narrative synthesis was performed instead. Six relevant articles were identified from the search. All studies were retrospective cohort studies with moderate to high risk of bias. Lack of consultant surgeon input, after hours transfer, need for intensive care bed and poor transfer documentation may have a role in interhospital transfer delays. Patients with public health insurance, multiple comorbidities and non-emergency medical conditions experience longer transfer request time and may be at risk of precipitating interhospital transfer delays. Transfer delays are seen in transfers over longer distances. There is a paucity of knowledge on what and how factors influence interhospital transfer delays in emergency general surgical patients. Well-designed prospective cohort studies are required to bridge this knowledge gap. Background Emergency general surgery is an emerging public health issue globally, with substantial healthcare burden. Interhospital transfer of critically unwell surgical patients has been the mainstay of bridging gaps in surgical coverage in regional and rural locations, despite evidence of greater morbidity and mortality. Delays in transfer invariably occurs and compounds the situation. Our aim was to examine the factors influencing interhospital transfer delays in emergency general surgical patients. Methods A systematic search of PubMED and EmBase, was performed by two researchers from 2020 to 23rd Feb 2021, for English articles related to interhospital transfer delays in emergency general surgical patients, with an age of >16. Articles were critically appraised and data were extracted into a pre‐specified data extraction form. No data was suitable for statistical analysis and a narrative synthesis was performed instead. Results Six relevant articles were identified from the search. All studies were retrospective cohort studies with moderate to high risk of bias. Lack of consultant surgeon input, after hours transfer, need for intensive care bed and poor transfer documentation may have a role in interhospital transfer delays. Patients with public health insurance, multiple comorbidities and non‐emergency medical conditions experience longer transfer request time and may be at risk of precipitating interhospital transfer delays. Transfer delays are seen in transfers over longer distances. Conclusion There is a paucity of knowledge on what and how factors influence interhospital transfer delays in emergency general surgical patients. Well‐designed prospective cohort studies are required to bridge this knowledge gap. Gaps in emergency surgical coverage in regional and rural locations are managed with interhospital transfers, despite inferior outcomes. A systematic review of the contemporary literature was performed and identified a paucity of knowledge on factors influencing interhospital transfer delays. More robust prospective cohort studies were recommended. |
Author | Maddern, Guy John Khoo, Teng‐Wei Trochsler, Markus Ivo Young, Edward |
Author_xml | – sequence: 1 givenname: Edward orcidid: 0000-0002-5262-5200 surname: Young fullname: Young, Edward email: edward.r.young@gmail.com organization: The University of Adelaide – sequence: 2 givenname: Teng‐Wei surname: Khoo fullname: Khoo, Teng‐Wei organization: The University of Adelaide – sequence: 3 givenname: Markus Ivo orcidid: 0000-0002-0650-9153 surname: Trochsler fullname: Trochsler, Markus Ivo organization: The Queen Elizabeth Hospital, The University of Adelaide – sequence: 4 givenname: Guy John orcidid: 0000-0003-2064-181X surname: Maddern fullname: Maddern, Guy John organization: The Queen Elizabeth Hospital, The University of Adelaide |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/35437859$$D View this record in MEDLINE/PubMed |
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Emergency general surgery is an emerging public health issue globally, with substantial healthcare burden. Interhospital transfer of critically... Emergency general surgery is an emerging public health issue globally, with substantial healthcare burden. Interhospital transfer of critically unwell surgical... BackgroundEmergency general surgery is an emerging public health issue globally, with substantial healthcare burden. Interhospital transfer of critically... BACKGROUNDEmergency general surgery is an emerging public health issue globally, with substantial healthcare burden. Interhospital transfer of critically... |
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StartPage | 1314 |
SubjectTerms | Emergency medical services general surgery Health care interhospital transfer Morbidity Narratives Patients Public health Rural areas Statistical analysis Surgery Synthesis systematic review |
Title | Factors influencing interhospital transfer delays in emergency general surgery: a systematic review and narrative synthesis |
URI | https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fans.17718 https://www.ncbi.nlm.nih.gov/pubmed/35437859 https://www.proquest.com/docview/2675063200 https://search.proquest.com/docview/2652582199 |
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