AB103. SOH25_AB_284. A retrospective study of complications caused by delays in transfers of sub-speciality surgical inpatients between level 3 general hospital and level 4 tertiary hospital

Background: Frequently surgical patients in level 3 hospitals require transfers to level 4 hospitals for specialized surgical management and procedures. Delays in these transfers can compromise their outcomes. This primary aim of this study is to evaluate transfer times from our level 3 hospital to tertiary centres in the region and the secondary aim will be the complications patient had because of these delays.

Methods: A review of timing to transfer and associated outcomes was performed.

Results: A total of 129 patients details were audited from our compiled data sources. Following exclusion criteria, 89 (61.1% male, 37.8% female) patients were transferred to 13 specialties across 7 hospitals. Patients waited from a range of 1 to 39 days. Median length of stay was 4 days. Ten percent of patients experienced documented complications as a result of delay in transfer including acute kidney injury and septic shock. Urological cases accounted for the majority of transfers (46.1%) followed by hepatobiliary 16.9%.

Conclusions: Delays in patients in transfers are frequent due to unavailability of beds in level 4 hospitals, compromising patient care. No comprehensive guidelines exist at present for interhospital, non-emergency patient transfer. Such guidelines and defined pathways for individual specialty transfers needs to developed which could reduce incidence of delays and optimize patient care.

Keywords: Complications; management; guidelines; transfers; delays