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The following is a summary of “Predictors of mortality among sepsis patients transferred from a rural, low-volume ED to an urban, high-volume hospital,” published in the April 2025 issue of American Journal of Emergency Medicine by Ameripour et al.  

Researchers conducted a retrospective study to examine how demographic factors, clinical care aspects, and biomarkers predicted individuals with sepsis-related mortality transferred from a rural, low-volume emergency department (ED) to an urban, high-volume, level-2 trauma center.  

They assessed 242 adults with severe sepsis (N = 242) within a community-based regional healthcare system. These individuals initially presented to 1 of 4 rural, low-volume EDs and were later transferred to an urban, high-volume, level-2 trauma center, where sepsis was identified at either location. In-hospital mortality and mortality within 30 days post-discharge were evaluated.  

The results showed that in-hospital mortality was associated with prior ICU admission (OR 5.02, 95% CI: 1.89–15.94, P = 0.002), sepsis identification before transfer (OR 0.29, 95% CI: 0.11–0.74, P = 0.01), and moderately abnormal lactate levels (OR 0.22, 95% CI: 0.05–0.79, P = 0.03). Mortality within 30 days post-discharge was linked to prior ICU admission (OR 3.28, 95% CI: 1.62–6.97, P = 0.001), abnormal red cell distribution width (OR 2.23, 95% CI: 1.11–4.60, P = 0.03), sepsis identification before transfer (OR 0.26, 95% CI: 0.12–0.54, P < 0.001), and moderately abnormal lactate levels (OR 0.32, 95% CI: 0.12–0.79, P = 0.02).  

Investigators concluded that early sepsis identification, along with consideration of prior ICU admission or comorbidities and abnormal red cell distribution width, could have improved care and prevented mortality in patients with sepsis transferred from a rural, low-volume ED to an urban, high-volume facility. 

Source: sciencedirect.com/science/article/abs/pii/S0735675725000191