# Impact of transfer from non-acute care centers on clinical outcomes in patients with congestive heart failure

## TL;DR

Patients with heart failure transferred from non-acute centers face higher in-hospital mortality compared to those admitted directly.

## Contribution

Demonstrates increased mortality risk in heart failure patients transferred from non-acute care centers after adjusting for demographics and comorbidities.

## Key findings

- Non-acute care transfers had 2.20 times higher odds of in-hospital mortality.
- Transferred patients were older, predominantly female, and White.
- All racial groups showed higher mortality rates in transferred patients.

## Abstract

To compare the clinical outcomes in patients with congestive heart failure who are transferred to an acute care hospital from non-acute care centers with patients who are admitted as regular hospital admissions.

This was a retrospective cohort study.

We utilized the National Inpatient Sample database from 2016 to 2018.

Our cohort consisted of hospitalized patients who were at least 18 years old with a primary diagnosis of congestive heart failure.

These patients were either transferred from non-acute centers or presented as regular hospital admissions.

We matched patients in a greedy nearest neighbor 1:1 model with caliper set at 0.2. Multivariable logistic regression, adjusted for age, sex, race and comorbidities, was used to compare mortality in our matched cohort.

This study included 35,010 non-acute care transfers and 951,189 regularly admitted patients. Compared to patients who were not transferred, non-acute care transfers were older, predominantly female, White and less racially diverse. After matching, there were 6689 patients in each cohort. When adjusted for age, race, sex and comorbidities, non-acute care transfers with congestive heart failure had 2.20 times higher odds of suffering in-hospital mortality compared to regular, non-transferred admissions (aOR 2.20, 95 % CI: 1.85–2.61; p < 0.001).

Our findings illustrate that non-acute care transfers are a vulnerable population that require additional medical support in the acute care setting.

•Non-acute care transfers were older, predominantly female and White.•Non-acute care transfers had 2.20 times higher odds of in-hospital mortality.•Every race had higher rates of mortality in the non-acute care transfer cohort.

Non-acute care transfers were older, predominantly female and White.

Non-acute care transfers had 2.20 times higher odds of in-hospital mortality.

Every race had higher rates of mortality in the non-acute care transfer cohort.