Effect of Critical Care Transport on Patients' Survival after Inter-Hospital Transport of Critically Ill Patients.
- Author:
Yong Joo PARK
1
;
Kyung Won LEE
;
Joo JEONG
;
Ik Wan JANG
;
Ki Ok AHN
;
Young Sun RO
;
Sang Do SHIN
Author Information
1. Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea.
- Publication Type:Clinical Trial ; Original Article
- Keywords:
Emergency medical services;
Transportation of patients;
Critical care;
Mortality
- MeSH:
Ambulances;
Critical Care*;
Critical Illness*;
Dataset;
Demography;
Diagnosis;
Emergency Medical Services;
Emergency Service, Hospital;
Heart Arrest;
Hospital Mortality;
Humans;
Information Systems;
Intensive Care Units;
Logistic Models;
Mortality;
Myocardial Infarction;
Odds Ratio;
Pilot Projects;
Respiratory Insufficiency;
Seoul;
Shock;
Stroke;
Transportation of Patients
- From:Journal of the Korean Society of Emergency Medicine
2017;28(1):1-16
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Critical care transport (CCT) has been known to be beneficial for inter-hospital transport of critically ill patients. Seoul Mobile Intensive Care Unit (SMICU) has been established and provided CCT in Seoul Metropolitan City since 2015. We tested the association between SMICU transport and hospital outcome for critically ill patients. METHODS: This is a before and after intervention study. SMICU group with cardiac arrest, acute myocardial infarction, acute stroke, major trauma, respiratory failure, and shock who were transported by SMICU from January to July 2016 were collected as an intervention group. Non-SMICU group with the same above diagnosis criteria who were transported by private ambulance services during same period in 2015. By National Emergency Department Information System (NEDIS), demographics were compared for original data and sampling data. Multivariable logistic regression analysis was done to calculate the adjusted odds ratios (AORs) with 95% confidence intervals (95% CIs) adjusting for potential confounders. RESULTS: Total 1,837 patients (128 SMICU and 1,709 non-SMICU group) for original dataset and 180 patients (60 SMICU and 120 non-SMICU group) for sampling dataset were finally analyzed. Hospital mortality rates are 22.7% in SMICU and 11.8% in non-SMICU in original dataset (p<0.001), 26.7% in SMICU and 31.7% in non-SMICU in sampling dataset (p=0.490), respectively. AOR (95% CIs) for hospital mortality by SMICU in original and sampling dataset were 0.80 (0.48-1.35) and 0.71 (0.33-1.51), respectively. CONCLUSION: The CCT for critically ill patients did not show significantly better hospital mortality in the pilot study.
