Nighttime Transfer out of Surgical ICU Are Associated With Higher Readmission

INTRODUCTION: Surgical intensive care unit (SICU) beds are a limited resource. We hypothesized that nighttime transfers from the SICU are associated with higher rates of SICU readmission. METHODS: All patients who underwent thoracic surgery between 2022 and 2024 were included. Patients were grouped based on time of transfer. Nighttime transfers occurred between 5:30 PM and 5:30 AM. Risk-adjusted multivariable logistic regression was used to assess the association between transfer timing and SICU readmission, complications, and mortality. RESULTS: A total of 216 patients were analyzed, including 169 Day Transfer patients and 47 Night Transfer patients. Baseline characteristics were similar between groups. The Day Transfer group experienced significantly longer transfer times compared with the Night Transfer group (564.1 minutes [IQR 474.3-653.9] vs. 324.1 minutes [IQR 203.4-444.7], p = 0.002). Complication rates were comparable between groups (12.8% Day vs. 14.9% Night, p = 0.71). However, Night Transfer patients had higher SICU readmission rates within 24 hours (10.6% vs. 1.2%, p = 0.001), within 7 days (19.2% vs. 5.2%, p = 0.002), and during the overall readmission rates (27.7% vs. 6.4%, p < 0.001). Nighttime transfer was independently associated with increased odds of SICU readmission at all measured time points. There were no significant differences in mortality or complication odds between groups. Conclusion Nighttime SICU transfers were associated with a significantly increased risk of readmission, indicating a potential opportunity to improve patient safety through optimized transfer timing and post-transfer care.