Comparison of Pre-transfer Risk Assessment Tools Used for Critically Ill Patient Transport: A Retrospective Study

Objective The objective of this study was to compare three scoring systems for pre-transfer risk assessment to enable the efficient utilization of transport infrastructure available while avoiding adverse events during interhospital patient transport. Methods This was a retrospective, cross-sectional study conducted in a tertiary care hospital situated in an aspirational district in Southern India. Trained personnel used three pre-transfer risk assessment tools to stratify the medical records of patients transported from the hospital during the study period. The data were analyzed to assess the sensitivity, specificity, and positive and negative likelihood ratios of the scoring systems. Results A total of 200 patient transports were included in the study. Cardiac emergency was the most common clinical diagnosis. A total of 35 patients had at least one major adverse event during transport. The Risk Score for Transport Patients (RSTP) classified 127 patients as high risk, the Transport Triage Tool (TTT) classified 133 as high risk, and the National Early Warning Score (NEWS2)-based tool classified 123 patients as high risk. Sensitivity and specificity of the RSTP scoring system to predict a major adverse event during transport were 77% and 39%, respectively. It also had a positive likelihood ratio of 1.27. Conclusion While the RSTP scoring system has the highest sensitivity and positive predictive value, further research is required to validate its performance in the Indian context.