Short-term outcomes and mortality after interhospital intensive care transportation: an observational prospective cohort study of 368 consecutive transports with a mobile intensive care unit

被引:28
作者
Strauch, Ulrich [1 ]
Bergmans, Dennis C. J. J. [1 ]
Winkens, Bjorn [2 ]
Roekaerts, Paul M. H. J. [1 ]
机构
[1] Maastricht Univ, Med Ctr, Dept Intens Care Med, NL-6200 MD Maastricht, Netherlands
[2] Maastricht Univ, Dept Methodol & Stat, NL-6200 MD Maastricht, Netherlands
关键词
CRITICALLY-ILL PATIENTS; SPECIALIST RETRIEVAL TEAM; INTRAHOSPITAL TRANSPORT; PATIENT TRANSPORT; REGIONALIZATION; PERFORMANCE; EXPERIENCE; DELIVERY; CENTERS; QUALITY;
D O I
10.1136/bmjopen-2014-006801
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives: To evaluate short-term outcomes and mortality after interhospital transportation of intensive care patients performed by a mobile intensive care unit (MICU). Setting: This study was performed in the tertiary care process of interhospital transportation using the local MICU system in the South East of the Netherlands. Participants: Between March 2009 and December 2011, all transports of adult patients being performed by the local MICU centre have been documented; data on 42 variables, including a 24 h follow-up Sequential Organ Failure Assessment (SOFA) score of 368 consecutive interhospital transports of intensive care patients, were recorded. In 24 cases, the follow-up SOFA score was missing, so 344 data sets were included. Interventions: No interventions have been done. Primary/secondary outcome measures: Primary outcome measures were the mean SOFA score before and 24 h after transport, and the 24 h post-transport mortality. Moreover, the differences between the groups of 24 h post-transport survivors and non-survivors have been analysed. Results: The mean SOFA score before transport was 8.8 for the whole population and 8.6 for those patients who were alive 24 h after transport, with a mean SOFA score of 8.4 after transport. The adverse events rate was 6.4%. Fourteen patients (4.1%) died within 24 h after transport. Patients in this group had a higher SOFA score, lower pH, higher age and more additional medical support devices than those patients in the survivor group. Conclusions: The non-significant decrease in the post-transport SOFA score and the lack of an association between transport and 24 h post-transport mortality indicates that in the study setting, interhospital transportation of intensive care patients performed by a MICU system was not associated with a clinically relevant deterioration of the patient.
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