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Effects of Medical Transport on Outcomes in Children Requiring Intensive Care

Atsushi Kawaguchi1,2, L Duncan Saunders2, Yutaka Yasui2

  • 1Department of Pediatrics, Pediatric Critical Care Medicine, University of Alberta, Edmonton, Alberta, Canada.

Journal of Intensive Care Medicine
|September 8, 2018
PubMed

Insights

Children transferred to a pediatric intensive care unit (PICU) from other hospitals had higher mortality than those admitted directly. This highlights challenges in regionalized critical care access for pediatric patients.

Area of Science:

  • Pediatric critical care
  • Health services research
  • Regionalized healthcare models

Background:

  • Centralizing care in regionalization models can delay specialist access.
  • This is particularly challenging in large geographic areas.
  • Impact on patient outcomes requires investigation.

Purpose of the Study:

  • To examine the effects of interhospital transfers on pediatric intensive care.
  • To compare outcomes in a Canadian regionalization model.

Main Methods:

  • Retrospective cohort design with matched pair analysis.
  • Compared children transferred by a specialized team (pediatric critical care transported [PCCT]) versus direct admissions from the pediatric emergency department (PED).
  • Outcome measured: mortality within 72 hours of critical care team contact.

Main Results:

  • 680 transports met inclusion criteria; 866 direct PED admissions.
  • Matched analysis included 493 pairs.
  • PCCT group had significantly higher 72-hour mortality (OR: 2.18, P = .032).

Conclusions:

  • Transported children from non-pediatric hospitals faced higher 72-hour mortality.
  • This occurred within a Canadian regionalized healthcare model.
  • Directly admitted children to the children's hospital PICU had better outcomes.
Abstract

Keywords:
Canadainterhospital transferpediatricstransport

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