title: Characteristics and outcomes of critically ill children following emergency transport by a specialist paediatric transport team.
abstract: OBJECTIVE
  We compared acute patients admitted to a single paediatric intensive care unit (PICU) following an emergency transfer by a specialist paediatric transport team and by other routes.
  
  
  METHODS
  This was a retrospective descriptive register-based study of consecutive admissions to a tertiary PICU in Sweden from 1 January 2008 to 31 December 2013. We compared the general characteristics of the cohorts, together with predicted death rates (PDR), PICU mortality, 30-day mortality, PICU length of stay (PICU LOS) and resource use.
  
  
  RESULTS
  Of the 3665 nonelective admissions, 221 patients received emergency transport from referring hospitals to the PICU by the specialist paediatric transport team. Their median age was lower (146 versus 482 days), PDR was higher (5.58% versus 1.39%), PICU LOS was longer (4.24 days versus 1.06 days), and they received more PICU-specific therapies. The standardised mortality ratio did not differ between the cohorts, and the PICU mortality was lower than predicted in both groups. The transport distance and mode of transport did not influence survival.
  
  
  CONCLUSIONS
  Children admitted to the PICU following emergency transfers by the specialist paediatric transport team were younger, sicker, received more PICU-specific therapies and had longer PICU LOS than other acutely admitted critically ill patients. This indicates that these transfers were appropriate.
authors.affiliation: Section of Anesthesiology and Intensive Care, Department of Physiology and Pharmacology, Karolinska Institutet, Astrid Lindgren Children's Hospital, Karolinska University Hospital Solna, Stockholm, Sweden. tova.hannegard-hamrin@karolinska.se.
authors.forename: Tova Hannegård
authors.initials: TH
authors.lastname: Hamrin
authors.affiliation: Section of Anesthesiology and Intensive Care, Department of Physiology and Pharmacology, Karolinska Institutet, Astrid Lindgren Children's Hospital, Karolinska University Hospital Solna, Stockholm, Sweden.
authors.forename: Jonas
authors.initials: J
authors.lastname: Berner
authors.affiliation: Childhood Cancer Research Unit Q6:05, Department of Women's and Children's Health, Karolinska Institutet, Astrid Lindgren Children's Hospital, Karolinska University Hospital Solna, Stockholm, Sweden.
authors.forename: Staffan
authors.initials: S
authors.lastname: Eksborg
authors.affiliation: Section of Anesthesiology and Intensive Care, Department of Physiology and Pharmacology, Karolinska Institutet, Astrid Lindgren Children's Hospital, Karolinska University Hospital Solna, Stockholm, Sweden.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Radell
authors.affiliation: Section of Anesthesiology and Intensive Care, Department of Physiology and Pharmacology, Karolinska Institutet, Astrid Lindgren Children's Hospital, Karolinska University Hospital Solna, Stockholm, Sweden.
authors.forename: Urban
authors.initials: U
authors.lastname: Fläring
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness / Q000401:mortality*; D003953:Diagnosis-Related Groups; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric / Q000592:standards / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010360:Patient Transfer / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016019:Survival Analysis; D013548:Sweden / Q000453:epidemiology; D062606:Tertiary Care Centers / Q000592:standards / Q000706:statistics & numerical data; D014187:Transportation of Patients / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data
keywords: Critically ill children; Outcomes; Paediatric intensive care; Paediatric transport; Safety