Faculty Collaboration Database

Pediatric Specialty Transport Teams Are Not Associated With Decreased 48-Hour Pediatric Intensive Care Unit Mortality: A Propensity Analysis of the VPS, LLC Database. Air Med J 2016;35(2):73-8

Date

03/30/2016

Pubmed ID

27021672

DOI

10.1016/j.amj.2015.12.003

Scopus ID

2-s2.0-84975503192 (requires institutional sign-in at Scopus site)   12 Citations

Abstract

OBJECTIVE: The purpose of this study was to determine if pediatric specialty pediatric team (SPT) interfacility-transported children from community emergency departments to a pediatric intensive care unit (PICU) have improved 48-hour mortality.

METHODS: This is a multicenter, historic cohort analysis of the VPS, LLC PICU clinical database (VPS, LLC, Los Angeles, CA) for all PICU directly admitted pediatric patients ≤ 18 years of age from January 1, 2007, to March 31, 2009. Categoric variables were analyzed by the chi-square and Mann-Whitney tests for non-normally distributed continuous variables. The propensity score was determined by multiple logistic regression analysis. Nearest neighbor matching developed emergency medical services SPT pairs by similar propensity score. Multiple regression analyses of the matched pairs determined the association of SPT with 48-hour PICU mortality. P values < .05 were considered significant.

RESULTS: This study included 3,795 PICU discharges from 12 hospitals. SPT-transported children were more severely ill, younger in age, and more likely to have a respiratory diagnosis (P < .0001). Unadjusted 48-hour PICU mortality was statistically significantly higher for SPT transports (2.04% vs. 0.070%, P = .0028). Multiple regressions adjusted for propensity score, illness severity, and PICU site showed no significant difference in 48-hour PICU mortality.

CONCLUSION: No significant difference in adjusted 48-hour PICU mortality for children transported by transport team type was discovered.

Author List

Meyer MT, Mikhailov TA, Kuhn EM, Collins MM, Scanlon MC

Authors

Michael T. Meyer MD Chief, Professor in the Pediatrics department at Medical College of Wisconsin
Theresa A. Mikhailov MD, PhD Professor in the Pediatrics department at Medical College of Wisconsin
Matthew C. Scanlon MD Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Child
Child, Preschool
Databases, Factual
Female
Humans
Infant
Infant, Newborn
Intensive Care Units, Pediatric
Male
Mortality
Patient Acuity
Patient Care Team
Pediatrics
Propensity Score
Transportation of Patients