The Canadian Paediatric Triage and Acuity Scale algorithm for interfacility transport.

Area of Science:

• Pediatric Emergency Medicine
• Healthcare Systems Analysis
• Clinical Triage Tools

Background:

• Accurate assessment of pediatric severity of illness is crucial for effective patient disposition and interfacility transport.
• The Canadian Paediatric Triage and Acuity Scale (PaedCTAS) is a widely used tool for assessing pediatric patient acuity.

Purpose of the Study:

• To evaluate the utility of the PaedCTAS tool in predicting patient disposition and outcomes for pediatric patients undergoing interfacility transport.
• To determine if PaedCTAS scores calculated at referring centers can predict the need for pediatric intensive care unit (PICU) admission.

Main Methods:

• Retrospective review of 194 pediatric patients (<17 years) transported to a tertiary pediatric center.
• Calculation of PaedCTAS disposition scores from referring center data at the time of transport consultation.
• Exclusion of patients transported for elective or planned interventions, investigations, or treatment.

Main Results:

• A PaedCTAS assessment of 1 was significantly associated with PICU admissions (OR 6.15, p < 0.0001).
• The area under the receiver-operating characteristic curve for PaedCTAS assessment of 1 predicting PICU admission was 0.72.
• Multivariate analysis showed a PaedCTAS assessment of 1 was associated with a length of hospital stay >3 days (OR 1.81, p = 0.05).

Conclusions:

• A PaedCTAS assessment of 1 appears to be a reliable predictor of PICU admissions and extended hospitalizations for pediatric patients.
• PaedCTAS scores derived at referral centers can provide valuable supplementary information for pediatric transport programs.
• The findings support the use of PaedCTAS in optimizing patient disposition and resource allocation for critically ill children.