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Characteristics and outcomes of interhospital transfers from level II to level I pediatric intensive care units.
Pediatr Crit Care Med. 2006 Nov; 7(6):536-40.PC

Abstract

OBJECTIVE

To examine the characteristics, resource utilization, and outcomes for transfer admissions from level II to level I pediatric intensive care units (PICUs).

DESIGN

Retrospective study.

SETTING

A 16-bed level I PICU in a tertiary care children's hospital.

PATIENTS

All transfer admissions from level II PICUs from January 1, 1997, through December 31, 2003; admissions for cardiac surgery were excluded. Patient characteristics, resource utilization, and outcomes were described and then compared across predefined strata (low <5%, moderate 5-30%, and high >30%) of predicted probability of death.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Of 168 transfer admissions, 45%, 30%, and 25% were in the low, moderate, and high mortality risk groups, respectively. Length of stay at the referring PICU was shortest for the high-risk admissions. The most frequent diagnoses among all risk groups were respiratory failure (49%) and sepsis (14%). High-risk admissions were more likely to receive advanced therapies such as extracorporeal membrane oxygenation (41.5% high risk vs. 39.2% moderate vs. 6.6% low risk, p < .01) and renal replacement therapy (34.2% vs. 17.7% vs. 2.6%, p < .01). The high-risk admissions had longer PICU length of stay and the highest death rates (34% vs. 10% vs. 4%, p < .01) when compared with the moderate- and low-risk admissions, respectively.

CONCLUSIONS

This study highlights significant differences in patient characteristics, resource utilization, and outcomes across mortality risk-stratified groups of critically ill and injured children transferred from level II to level I PICU care. Further studies are warranted to investigate decision making that prompt inter-PICU transfers.

Authors+Show Affiliations

University of Michigan, Ann Arbor, MI, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17006392

Citation

Odetola, Folafoluwa O., et al. "Characteristics and Outcomes of Interhospital Transfers From Level II to Level I Pediatric Intensive Care Units." Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, vol. 7, no. 6, 2006, pp. 536-40.
Odetola FO, Shanley TP, Gurney JG, et al. Characteristics and outcomes of interhospital transfers from level II to level I pediatric intensive care units. Pediatr Crit Care Med. 2006;7(6):536-40.
Odetola, F. O., Shanley, T. P., Gurney, J. G., Clark, S. J., Dechert, R. E., Freed, G. L., & Davis, M. M. (2006). Characteristics and outcomes of interhospital transfers from level II to level I pediatric intensive care units. Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 7(6), 536-40.
Odetola FO, et al. Characteristics and Outcomes of Interhospital Transfers From Level II to Level I Pediatric Intensive Care Units. Pediatr Crit Care Med. 2006;7(6):536-40. PubMed PMID: 17006392.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characteristics and outcomes of interhospital transfers from level II to level I pediatric intensive care units. AU - Odetola,Folafoluwa O, AU - Shanley,Thomas P, AU - Gurney,James G, AU - Clark,Sarah J, AU - Dechert,Ronald E, AU - Freed,Gary L, AU - Davis,Matthew M, PY - 2006/9/29/pubmed PY - 2007/3/1/medline PY - 2006/9/29/entrez SP - 536 EP - 40 JF - Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies JO - Pediatr Crit Care Med VL - 7 IS - 6 N2 - OBJECTIVE: To examine the characteristics, resource utilization, and outcomes for transfer admissions from level II to level I pediatric intensive care units (PICUs). DESIGN: Retrospective study. SETTING: A 16-bed level I PICU in a tertiary care children's hospital. PATIENTS: All transfer admissions from level II PICUs from January 1, 1997, through December 31, 2003; admissions for cardiac surgery were excluded. Patient characteristics, resource utilization, and outcomes were described and then compared across predefined strata (low <5%, moderate 5-30%, and high >30%) of predicted probability of death. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of 168 transfer admissions, 45%, 30%, and 25% were in the low, moderate, and high mortality risk groups, respectively. Length of stay at the referring PICU was shortest for the high-risk admissions. The most frequent diagnoses among all risk groups were respiratory failure (49%) and sepsis (14%). High-risk admissions were more likely to receive advanced therapies such as extracorporeal membrane oxygenation (41.5% high risk vs. 39.2% moderate vs. 6.6% low risk, p < .01) and renal replacement therapy (34.2% vs. 17.7% vs. 2.6%, p < .01). The high-risk admissions had longer PICU length of stay and the highest death rates (34% vs. 10% vs. 4%, p < .01) when compared with the moderate- and low-risk admissions, respectively. CONCLUSIONS: This study highlights significant differences in patient characteristics, resource utilization, and outcomes across mortality risk-stratified groups of critically ill and injured children transferred from level II to level I PICU care. Further studies are warranted to investigate decision making that prompt inter-PICU transfers. SN - 1529-7535 UR - https://www.unboundmedicine.com/medline/citation/17006392/Characteristics_and_outcomes_of_interhospital_transfers_from_level_II_to_level_I_pediatric_intensive_care_units_ L2 - https://doi.org/10.1097/01.PCC.0000243722.71203.5C DB - PRIME DP - Unbound Medicine ER -