P-10 Comparison of severe respiratory events requiring ICU admission in patients transferred from secondary hospitals and those from long term care beds in institutions and hospitals = P-10 Comparison of severe respiratory events requiring ICU admission in patients transferred from secondary hospitals and those from long term care beds in institutions and hospitals

다국어 초록 (Multilingual Abstract)

Background: We aim to identify the clinical features and outcomes of patients with severe respiratory events transferred to the intensive care unit (ICU) of a tertiary referral hospital from secondary hospitals and long-term care beds in institutions and hospitals (LTCHs).
Methods: Following a retrospective review of clinical data between 2010 and 2016, we included a total of 253 patients(142 from secondary hospitals vs. 111 from LTCHs) requiring ICU admission transferred from another hospital due to severe respiratory events.
Results: Mean age was higher (76 years vs. 71 years, p=0.001) and neurological comorbidities were more common (53.2% vs. 22.0%) in the LTCHs group. Pneumonia was the most common cause of ICU admission in both groups (89.2% [99/111] in LCTH transfers; 81.7% [116/142] in secondary hospital transfers). Multidrug-resistant (MDR) respiratory pathogens (47.7% vs. 14.4%, p＜0.0001), the need for invasive ventilation (69.4% vs. 55.7%, p=0.018), and the development of acute respiratory distress syndrome (26.1% vs. 7.9%, p＜0.0001) were more common in the LTCH group. However, there were no significant differences in hospital mortality (19.8% vs. 22.7%, p=0.800) between the two groups. Aging and lower serum albumin level were independent predictors of in-hospital mortality in total subjects.
Conclusion: The clinical progresses were worse in the LTCH group regardless of in-hospital mortality. Considering the prevalence of MDR pathogens, selection of appropriate antibiotics in patients with pneumonia is essential, especially in patients transferred from LTCHs.