Does Timing Matter?: Timing and Outcomes Among Early Unplanned PICU Transfers

Area of Science:

• Pediatric critical care medicine
• Healthcare quality improvement
• Emergency medicine

Background:

• Early intensive care unit (ICU) transfers from inpatient floors within 24 hours of admission are used by institutions as a marker for emergency department (ED) care quality.
• Limited data exist on whether patient characteristics or clinical outcomes vary based on the specific timing of ICU transfer within this 24-hour window.

Purpose of the Study:

• To evaluate if patient characteristics and clinical outcomes differ among pediatric patients transferred to the ICU within 24 hours of admission, based on the timing of transfer (0-6, 6-12, or 12-24 hours).

Main Methods:

• Retrospective cohort study of pediatric patients (≤21 years) transferred from an ED to an inpatient floor and then to an ICU within 24 hours.
• Comparison of patient characteristics and clinical outcomes, including critical interventions, length of stay, and mortality, across different ICU transfer timing groups.

Main Results:

• A total of 841 patients met the inclusion criteria.
• Patient demographics and clinical outcomes, such as intervention timing, length of stay, and mortality, were comparable across the three transfer timing groups (0-6 hours, 6-12 hours, 12-24 hours).

Conclusions:

• For pediatric patients transferred to the ICU within 24 hours of ED admission, the timing of transfer within this window does not appear to significantly impact patient characteristics or clinical outcomes.
• These findings suggest that the specific timing of early ICU transfer may not be a differentiating factor for quality assessment in pediatric emergency care.