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Research Snapshot Theater: Shock, Adult III

Delayed ICU Transfer Increases Mortality in General Ward Shock Patients: Retrospective Cohort Study

Sunday, March 22, 2026
12:15 PM - 1:15 PM Central Time
Location: Connections Central - RST 16
  • WY

    Wanhong Yin, n/a

    Dr.
    West China Hospital

    Disclosure information not submitted.

  • tongjuan zou, n/a (she/her/hers)

    West China Hospital Sichuan University, China (People's Republic)

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • NC

    NGAN CHANSOKHON, N/A

    Dr.
    West China Hospital, Sichuan University, Sichuan, China (People's Republic)

    Disclosure information not submitted.

Introduction: Delayed intensive care unit (ICU) admission in hospitalized patients with shock is associated with worse outcomes. However, large-scale evidence specifically addressing the impact of ICU transfer timing in ward-onset shock is lacking. We aimed to evaluate the association between transfer delay and mortality, and whether early point-of-care ultrasound (POCUS) could improve clinical outcomes.


Methods: We conducted a retrospective cohort study of adult patients diagnosed with shock in general wards and subsequently transferred to the ICU at West China Hospital, Sichuan University, between January 2019 and January 2024. Patients were stratified into three groups based on transfer time from shock onset: < 3 hours (Group 1), 3–6 hours (Group 2), and >6 hours (Group 3). The primary outcome was in-hospital mortality; secondary outcomes included 28-day mortality, ICU/hospital length of stay (LOS), and shock duration. Multivariable logistic regression was used to adjust for confounders (age, APACHE II, SOFA). The impact of early POCUS (within 6 hours of shock onset) on outcomes was also analyzed.


Results: A total of 3,535 shock patients were included: 2,849 (80.6%) in Group 1, 150 (4.2%) in Group 2, and 536 (15.2%) in Group 3. In-hospital mortality increased with transfer delay (Group 1: 18.0%; Group 2: 39.7%; Group 3: 51.5%; p< 0.001). After adjustment, transfer delays >6 hours remained an independent predictor of in-hospital mortality (adjusted OR: 3.27; 95% CI: 2.65–4.03) and 28-day mortality (adjusted OR: 2.84; 95% CI: 2.30–3.52). Each additional hour of delay was associated with a 2–3% increase in mortality. Early POCUS (performed in 7.1% of patients) was independently associated with reduced in-hospital (16.7% vs. 24.6%; p=0.006) and 28-day mortality (13.9% vs. 22.0%; p=0.004), as well as shorter ICU stay and shock duration.


Conclusions: Delayed ICU transfer in patients with ward-onset shock is strongly associated with increased mortality and longer ICU/hospital stays. Admission within 3 hours of shock onset and early application of POCUS are independently associated with improved survival. Our findings support institutional strategies that prioritize rapid ICU triage and early hemodynamic ultrasound in shock patients.