title: Pediatric Specialty Transport Teams Are Not Associated With Decreased 48-Hour Pediatric Intensive Care Unit Mortality: A Propensity Analysis of the VPS, LLC Database.
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.
  
  
  CONCLUSIONS
  No significant difference in adjusted 48-hour PICU mortality for children transported by transport team type was discovered.
authors.affiliation: Medical College of Wisconsin, Milwaukee, WI, USA. Electronic address: mtmeyer@mcw.edu.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Meyer
authors.affiliation: Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Theresa A
authors.initials: TA
authors.lastname: Mikhailov
authors.affiliation: Children's Hospital of Wisconsin, Milwaukee, WI, USA.
authors.forename: Evelyn M
authors.initials: EM
authors.lastname: Kuhn
authors.affiliation: Curative Care Network, Inc, Milwaukee, WI, USA.
authors.forename: Maureen M
authors.initials: MM
authors.lastname: Collins
authors.affiliation: Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Scanlon
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D008297:Male; D009026:Mortality; D062072:Patient Acuity; D010348:Patient Care Team; D010372:Pediatrics; D057216:Propensity Score; D014187:Transportation of Patients; D000078329:Workforce