Period of hospitalization and mortality in transferred versus non-transferred COVID-19 patients: results from Germany

• Published in: Scientific reports Vol. 14; no. 1; p. 7338
• Main Authors: Suski, Pascal, Jörres, Rudolf A., Engelhardt, Sebastian, Kahnert, Kathrin, Lenherr, Katharina, Bauer, Andreas, Budweiser, Stephan
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 28.03.2024; Nature Publishing Group; Nature Portfolio
• Subjects: 692/699/255/2514; 692/700/228; COVID-19; COVID-19 - epidemiology; COVID-19 - therapy; Health care; Hospital Mortality; Hospitalization; Hospitals; Humanities and Social Sciences; Humans; Intensive Care Units; Mortality; multidisciplinary; Patient Transfer; Patients; Regression Analysis; Retrospective Studies; Science; Science (multidisciplinary); Germany
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-57272-y

COVID-19 was a challenge for health-care systems worldwide, causing large numbers of hospitalizations and inter-hospital transfers. We studied whether transfer, as well as its reason, was associated with the duration of hospitalization in non-ICU and ICU patients. For this purpose, all patients hospitalized due to COVID-19 between August 1st and December 31st, 2021, in a network of hospitals in Southern Germany were comprehensively characterized regarding their clinical course, therapy, complications, transfers, reasons for transfer, involved levels of care, total period of hospitalization and in-hospital mortality, using univariate and multiple regression analyses. While mortality was not significantly associated with transfer, the period of hospitalization was. In non-ICU patients ( n  = 545), median (quartiles) time was 7.0 (4.0–11.0) in non-transferred ( n  = 458) and 18.0 (11.0–29.0) days in transferred ( n  = 87) patients ( p  < 0.001). In ICU patients ( n  = 100 transferred, n  = 115 non-transferred) it was 12.0 (8.3–18.0) and 22.0 (15.0–34.0) days ( p  < 0.001). Beyond ECMO therapy (4.5%), reasons for transfer were medical (33.2%) or capacity (61.9%) reasons, with medical/capacity reasons in 32/49 of non-ICU and 21/74 of ICU patients. Thus, the transfer of COVID-19 patients between hospitals was associated with longer periods of hospitalization, corresponding to greater health care utilization, for which specific patient characteristics and clinical decisions played a role.