title: High incidence of adverse events during intra-hospital transport of critically ill patients and new related risk factors: a prospective, multicenter study in China.
abstract: BACKGROUND
  The aim of the present study was to investigate the incidence of adverse events (AEs) during intra-hospital transport (IHT) of critically ill patients and evaluate the risk factors associated with these events.
  
  
  METHODS
  This prospective multicenter observational study was performed in 34 intensive care units in China during 20 consecutive days from 5 November to 25 November 2012. All consecutive patients who required IHT for diagnostic testing or therapeutic procedures during the study period were included. All AEs that occurred during IHT were recorded. The incidence of AEs was defined as the rate of transports with at least one AE. The statistical analysis included a description of demographic and clinical characteristics of the cohort as well as identification of risk factors for AEs during IHT by univariate and multivariate logistic regression analyses.
  
  
  RESULTS
  In total, 441 IHTs of 369 critically ill patients were analyzed. The overall incidence of AEs was 79.8% (352 IHTs). The proportion of equipment- and staff-related adverse events was 7.9% (35 IHTs). The rate of patient-related adverse events (P-AEs) was 79.4% (349 IHTs). The rates of vital sign-related P-AEs and arterial blood gas analysis-related P-AEs were 57.1% (252 IHTs) and 46.9% (207 IHTs), respectively. The incidence of critical P-AEs was 33.1% (146 IHTs). The rates of vital sign-related critical P-AEs and arterial blood gas analysis-related critical P-AEs were 22.9% (101 IHTs) and 15.0% (66 IHTs), respectively. All data collected in our study were considered potential risk factors. In the multivariate analysis, predictive factors for P-AEs were pH, partial pressure of carbon dioxide in arterial blood, lactate level, glucose level, and heart rate before IHT. Furthermore, the Acute Physiology and Chronic Health Evaluation II score, partial pressure of oxygen in arterial blood, lactate level, glucose level, heart rate, respiratory rate, pulse oximetry, and sedation before transport were independent influential factors for critical P-AEs during IHT.
  
  
  CONCLUSIONS
  The incidence of P-AEs during IHT of critically ill patients was high. Risk factors for P-AEs during IHT were identified. Strategies are needed to reduce their frequency.
  
  
  BACKGROUND
  Chinese Clinical Trial Register identifier ChiCTR-OCS-12002661. Registered 5 November 2012.
authors.affiliation: Department of Critical Care Medicine, the Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China. jialiu179@163.com.
authors.forename: Liu
authors.initials: L
authors.lastname: Jia
authors.affiliation: Department of Critical Care Medicine, the Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China. icuwanghongliang@163.com.
authors.forename: Hongliang
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Critical Care Medicine, the Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China. gaoyang0312@126.com.
authors.forename: Yang
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Critical Care Medicine, the Third Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China. dr633@foxmail.com.
authors.forename: Haitao
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Critical Care Medicine, the Third Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China. icuyukaijiang@163.com.
authors.forename: Kaijiang
authors.initials: K
authors.lastname: Yu
mesh_terms: D000368:Aged; D002681:China / Q000453:epidemiology; D003422:Critical Care / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data*; D016638:Critical Illness / Q000453:epidemiology; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010360:Patient Transfer / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012307:Risk Factors