Interhospital transport of critically ill patients: A prospective observational study of patient and transport characteristics.

ICU cohort study critically ill intensive care intensive care unit inter facility inter hospital patient transfer transport

Journal

Acta anaesthesiologica Scandinavica
ISSN: 1399-6576
Titre abrégé: Acta Anaesthesiol Scand
Pays: England
ID NLM: 0370270

Informations de publication

Date de publication:
Feb 2022
Historique:
revised: 20 09 2021
received: 06 03 2021
accepted: 15 10 2021
pubmed: 24 11 2021
medline: 27 1 2022
entrez: 23 11 2021
Statut: ppublish

Résumé

The cohort of critically ill patients transported between Intensive Care Units (ICUs) in Norway has not been studied previously. The aim of this study was to describe the characteristics of patients and transports for different types of interhospital transfers and explore whether there were differences in morbidity and mortality between the different transfer categories and the general Norwegian ICU population. All transports of critically ill adult patients transferred between two geographically different Intensive Care Units during a one-year period were registered. Patient and transport data were obtained from The Norwegian Intensive Care Registry, The Norwegian Cause of Death Registry, the hospital Electronic Patient Journal, the Air Ambulance Journal System, and the Emergency Medical Communication Centre database. 821 transports of 788 surgical and medical patients were enrolled. Simplified Acute Physiology Scores (SAPSII) were 43, 36 and 38 for urgent secondary transport, non-urgent secondary transport and return transfers, respectively. These were comparable to nationwide SAPSII scores that were 40 for university hospitals and 34 for local hospitals during the same time period. The return transfers had a median SOFA-score of 4.7 and 53% were mechanically ventilated. Only 33% of return transfers were performed by established teams. Intensive care patients transferred between ICUs are as critically ill as the rest of the ICU population, with a similar morbidity and mortality. The return transfers of ICU-patients appear under-triaged compared to secondary transports in terms of allocated resources.

Sections du résumé

BACKGROUND BACKGROUND
The cohort of critically ill patients transported between Intensive Care Units (ICUs) in Norway has not been studied previously. The aim of this study was to describe the characteristics of patients and transports for different types of interhospital transfers and explore whether there were differences in morbidity and mortality between the different transfer categories and the general Norwegian ICU population.
METHODS METHODS
All transports of critically ill adult patients transferred between two geographically different Intensive Care Units during a one-year period were registered. Patient and transport data were obtained from The Norwegian Intensive Care Registry, The Norwegian Cause of Death Registry, the hospital Electronic Patient Journal, the Air Ambulance Journal System, and the Emergency Medical Communication Centre database.
RESULTS RESULTS
821 transports of 788 surgical and medical patients were enrolled. Simplified Acute Physiology Scores (SAPSII) were 43, 36 and 38 for urgent secondary transport, non-urgent secondary transport and return transfers, respectively. These were comparable to nationwide SAPSII scores that were 40 for university hospitals and 34 for local hospitals during the same time period. The return transfers had a median SOFA-score of 4.7 and 53% were mechanically ventilated. Only 33% of return transfers were performed by established teams.
CONCLUSION CONCLUSIONS
Intensive care patients transferred between ICUs are as critically ill as the rest of the ICU population, with a similar morbidity and mortality. The return transfers of ICU-patients appear under-triaged compared to secondary transports in terms of allocated resources.

Identifiants

pubmed: 34811736
doi: 10.1111/aas.14005
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

248-255

Subventions

Organisme : Stiftelsen Norsk Luftambulanse

Informations de copyright

© 2021 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

Références

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Auteurs

Helge Eiding (H)

Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
Department of Research and Development, Norwegian Air Ambulance Foundation, Oslo, Norway.

Ulf E Kongsgaard (UE)

Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
Institute of Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway.

Theresa M Olasveengen (TM)

Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
Institute of Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway.

Fridtjof Heyerdahl (F)

Department of Research and Development, Norwegian Air Ambulance Foundation, Oslo, Norway.
Institute of Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway.
Division of Prehospital Services, Oslo University Hospital, Oslo, Norway.

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