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Incidence and predictors of adverse events and outcomes for adult critically ill patients transferred by paramedics to a tertiary care medical facility
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Alabdali, Abdullah, Trivedy, Chetan R., Aljerian, Nawfal, Kimani, Peter K. and Lilford, Richard (2017) Incidence and predictors of adverse events and outcomes for adult critically ill patients transferred by paramedics to a tertiary care medical facility. Journal of Health Specialties, 5 (4). pp. 206-211. doi:10.4103/jhs.JHS_19_17 ISSN 2468-6360.
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WRAP-Incidence-adverse-critically-patients-transferred-paramedics-facility-Kimani-2017.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution. Download (720Kb) | Preview |
Official URL: http://dx.doi.org/10.4103/jhs.JHS_19_17
Abstract
Objective: The aim of this study was to determine the incidence of adverse events and patients’ outcomes in inter‑facility critical care transfers by paramedics.
Methods: We conducted a retrospective cohort study of adults undergoing inter‑facility transfer to a tertiary medical facility by paramedics. We included all patients transferred between 1st June, 2011 and 31st December, 2014. The primary outcome is in‑transit adverse event and the secondary outcome is in‑hospital mortality. Multiple logistic regression models were fitted to assess predictor variables for adverse events and in‑hospital mortality.
Results: The incidence of adverse events was 13.7% (31/227 patients had in‑transit adverse event); the most common adverse events reported were desaturation and hypotension. A unit increase in risk score for transported patients (RSTP) significantly increased the occurrence of adverse events (adjusted odds ratio [OR]: 1.36, 95% confidence interval [CI]: 1.07–1.72 and adjusted P = 0.01). Compared to medical patients, cardiac patients were less likely to develop adverse events (adjusted OR: 0.117, 95% CI: 0.02–0.52 and adjusted P < 0.01). The in‑hospital mortality was 30.4% and 30-day survival was 68.1%. For two patients whose age differed by 1 year, the older patient was more likely to die (adjusted OR: 1.03, 95% CI: 1.01–1.05 and P < 0.01) and a unit increase in RSTP significantly increased occurrence of in‑hospital mortality (adjusted OR: 1.30, 95% CI: 1.0–1.60 and P = 0.01).
Conclusion: The incidence of adverse events was 13.7%. The most common observed adverse events were desaturation and hypotension. In‑hospital mortality was 30.4% and 30-day survival was 68.1%.
| Item Type: | Journal Article | ||||||
|---|---|---|---|---|---|---|---|
| Subjects: | R Medicine > RA Public aspects of medicine | ||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||
| Library of Congress Subject Headings (LCSH): | Critical care medicine, Transport of sick and wounded, Ambulance service, Allied health personnel | ||||||
| Journal or Publication Title: | Journal of Health Specialties | ||||||
| Publisher: | Medknow Publications | ||||||
| ISSN: | 2468-6360 | ||||||
| Official Date: | October 2017 | ||||||
| Dates: |
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| Volume: | 5 | ||||||
| Number: | 4 | ||||||
| Page Range: | pp. 206-211 | ||||||
| DOI: | 10.4103/jhs.JHS_19_17 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||
| Date of first compliant deposit: | 12 January 2018 | ||||||
| Date of first compliant Open Access: | 12 January 2018 | ||||||
| RIOXX Funder/Project Grant: |
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