Pediatric interfacility transport effects on mortality and length of stay

作     者：Rod M.Shinozaki Andreas Schwingshackl Neeraj Srivastava Tristan Grogan Robert B.Kelly Rod M.Shinozaki;Andreas Schwingshackl;Neeraj Srivastava;Tristan Grogan;Robert B.Kelly

作者机构：David Geffen School of Medicine at UCLALos AngelesCAUSA University of CaliforniaIrvineIrvineCAUSA Children’s Hospital of Orange County1201 West La Veta AvenueOrangeCA92868USA 

出 版 物：《World Journal of Pediatrics》 (世界儿科杂志（英文版）)

年 卷 期：2021年第17卷第4期

页      面：400-408页

核心收录：

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 100202[医学-儿科学] 10[医学] 

基　　金：Statistical analysis by TG was funded by NIH National Center for Advancing Translational Science(UCLA CTSI grant number:UL1TR001881) 

主　　题：Helicopter Hospital length of stay Pediatric critical care Pediatric intensive care unit Transport medicine 

摘      要：Background We aimed to evaluate the effects of interfacility pediatric critical care transport response time,physician presence during transport,and mode of transport on mortality and length of stay(LOS)among pediatric *** hypothesized that a shorter response time and helicopter transports,but not physician presence,are associated with lower mortality and a shorter *** Retrospective,single-center,cohort study of 841 patients(19 years)transported to a quaternary pediatric intensive care unit and cardiovascular intensive care unit between 2014 and 2018 utilizing patient charts and transport *** linear and logistic regression analyses adjusted for age,diagnosis,mode of transport,response time,stabilization time,return duration,mortality risk(pediatric index of mortality-2 and pediatric risk of mortality-3),and inotrope,vasopressor,or mechanical ventilation presence on *** Four hundred and twenty-eight(50.9%)patients were transported by helicopter,and 413(49.1%)were transported by *** accompanied 239(28.4%)*** median response time was 2.0(interquartile range 1.4–2.9)*** physician presence increased the median response time by 0.26 hours(P=0.020),neither physician presence nor response time significantly affected mortality,ICU length of stay(ILOS)or hospital length of stay(HLOS).Helicopter transports were not significantly associated with mortality or ILOS,but were associated with a longer HLOS(3.24 days,95%confidence interval 0.59–5.90)than ambulance transports(P=0.017).Conclusions These results suggest response time and physician presence do not significantly affect mortality or *** may reflect the quality of pre-transport care and medical control *** transports were only associated with a longer *** analysis provides a framework for examining transport workforce needs and associated costs.