Μαρβάκη Χριστίνα, Ομότιμη Καθηγήτρια, Τμήμα Νοσηλευτικής, Πανεπιστήμιο Δυτικής Αττικής
Κουτσούκου Αντωνία, Επίκουρη καθηγήτρια, Τμήμα Ιατρικής, ΕΚΠΑ
Καλογιάννη Αντωνία, Επίκουρη καθηγήτρια Τμήμα Νοσηλευτικής, Πανεπιστήμιο Δυτικής Αττικής
“Correlation study between the transfer duration of critically ill patients and the short-term outcome”
Siomou Eleftheria1 Marvaki Christina 2 Kalogianni Antonia 3
1 RΝ MSc Nurse
2 Emeritus Professor, Department of Nursing, University of West Attica
3 Assistant Profesor Nursing department University of West Attica
Introduction: Critically ill patients should be urgently treated in the place of the initial incident in order to improve their condition. The individuality of their transfer underlies the short-term outcome, thus it should be severely considered.
Aim: The purpose of this study is to investigate the correlation between the transfer duration of critically ill patients and the short-term outcome.
Material/Method: 155 critically ill patients took part of this prospective cohort study that lasted 7 months. All data was collected with a special form “Patient Card” that included: demographic characteristics, the exact time of the emergency call and the ED admission, the initial diagnosis, the APACHE II score, the ED outcome and the possibility of a direct admission to OR, ICU or immediate interhospital transportation. Dead on arrival or 24 hours after that were excluded from the control group. The data was analyzed using SPSS version 22.0. P-value less than 0,05 (P ≤0.05) was considered as statistically significant test result.
Results: All 155 critically ill patients admitted to ED after emergency call were included. The mean age was 58,89±20.83 years, the mean APACHE II score was 23,9±5.71 and the mean transport duration was 39,91±21.78 with minimum duration 11 minutes and maximum 161 minutes. Concerning the cause of the ED induction, patients with multiple injuries comprised the majority of the control group with percentage 23,9% (N=37). Subsequently, with percentage 20% (N=31) followed patients who were reported with infrequent diseases, called in this study as “other ailment” (acute pulmonary edema, craniocerebral injury, acute renal failure, intoxication, epileptic seizures, coma etc were grouped due to low frequency). The 16,8% (N=26) of the control group were diagnosed with cardiac urgency (cardiac arrest, ACS), 12.9% (Ν=20) patients were diagnosed with respiratory failure and 7.7% (Ν=12) of the patients admitted due to some kind of infection. With lower percentages followed patients diagnosed with celebrovascular disease (Ν=8, 5.2%), allergic shock (Ν=6, 3.9%), electrolyte imbalance (Ν=6,3.9%), surgical urgency (Ν=5, 3.2%) and severe burn (Ν=4, 2.6%). Regarding to the egress from ED, 51 patients inducted directly in the ICU, 24 patients were stretchered to OD, and 26 patients were transferred to a third grade hospital/or specialized center.
Conclusions: The study documented that delayed transfer patients had higher sequential fatal possibility. In particular, the transport duration of critically ill patients till their arrival to ED is statistically important (p<0.004), as for every single minute that goes by during transport, lower possibility for amelioration was expected. Moreover, findings showed that the higher APACHE II a patient scored, the less chance of health improvement he had. These findings point to the need of redesigning prehospital healthcare services to account for the importance of the transport duration for the critically ill patients.
Keywords: Critically ill patient, Critical care transport, Emergency intake, Transport duration, ER/ED
Corresponding author: Siomou Eleftheria email@example.com
Critically ill patient, Critical care transport, Emergency intake, Transport duration, ER/ED