title: Comparison of risks factors for unplanned ICU transfer after ED admission in patients with infections and those without infections.
abstract: BACKGROUND
  The objectives of this study were to compare the risk factors for unplanned intensive care unit (ICU) transfer after emergency department (ED) admission in patients with infections and those without infections and to explore the feasibility of using risk stratification tools for sepsis to derive a prediction system for such unplanned transfer.
  
  
  METHODS
  The ICU transfer group included 313 patients, while the control group included 736 patients randomly selected from those who were not transferred to the ICU. Candidate variables were analyzed for association with unplanned ICU transfer in the 1049 study patients.
  
  
  RESULTS
  Twenty-four variables were associated with unplanned ICU transfer. Sixteen (66.7%) of these variables displayed association in patients with infections and those without infections. These common risk factors included specific comorbidities, physiological responses, organ dysfunctions, and other serious symptoms and signs. Several common risk factors were statistically independent.
  
  
  CONCLUSIONS
  The risk factors for unplanned ICU transfer in patients with infections were comparable to those in patients without infections. The risk factors for unplanned ICU transfer included variables from multiple dimensions that could be organized according to the PIRO (predisposition, insult/infection, physiological response, and organ dysfunction) model, providing the basis for the development of a predictive system.
authors.affiliation: Department of Emergency Medicine, China Medical University Hospital, No. 2 Yude Road, North District, Taichung City 404, Taiwan ; School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan ; Department of Industrial Engineering & Enterprise Information, Tunghai University, Taichung 407, Taiwan.
authors.forename: Jeffrey Che-Hung
authors.identifier: 0000-0002-8001-6154
authors.initials: JC
authors.lastname: Tsai
authors.affiliation: Department of Emergency Medicine, Cheng-Ching General Hospital, Taichung 407, Taiwan.
authors.forename: Ching-Wan
authors.initials: CW
authors.lastname: Cheng
authors.affiliation: Department of Industrial Engineering & Enterprise Information, Tunghai University, Taichung 407, Taiwan.
authors.forename: Shao-Jen
authors.identifier: 0000-0003-2230-6775
authors.initials: SJ
authors.lastname: Weng
authors.affiliation: Program for Health Administration, Tunghai University, Taichung 407, Taiwan.
authors.forename: Chin-Yin
authors.initials: CY
authors.lastname: Huang
authors.affiliation: Institute of Emergency and Critical Care Medicine, College of Medicine, National Yang-Ming University, Taipei 112, Taiwan.
authors.forename: David Hung-Tsang
authors.initials: DH
authors.lastname: Yen
authors.affiliation: Department of Emergency Medicine, China Medical University Hospital, No. 2 Yude Road, North District, Taichung City 404, Taiwan ; School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan.
authors.forename: Hsiu-Ling
authors.initials: HL
authors.lastname: Chen
mesh_terms: D016022:Case-Control Studies; D004636:Emergency Service, Hospital; D006801:Humans; D007362:Intensive Care Units; D010343:Patient Admission; D010360:Patient Transfer; D012307:Risk Factors