J Korean Soc Emerg Med.  2017 Feb;28(1):1-16. 10.0000/jksem.2017.28.1.1.

Effect of Critical Care Transport on Patients' Survival after Inter-Hospital Transport of Critically Ill Patients

• Park YJ
• Lee KW
• Jeong J
• Jang IW
• Ahn KO
• Ro YS
• Shin SD

• KMID: 2425172
• DOI: http://doi.org/10.0000/jksem.2017.28.1.1

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.

Keyword

Emergency medical services; Transportation of patients; Critical care; Mortality

MeSH Terms

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