Citation Information :
Zirpe KG, Tiwari AM, Kulkarni AP, Govil D, Dixit SB, Munjal M, Samveddam S, Sing YP, Kuragayala SD, Chandankhede SR, Patil V, Agarwala B, Jain S, Pattajoshi S, Padyanya M, Kumar A, Joshi Z, Sircar M, Khunteta S, Pande R, Mishra R. Adverse Events during Intrahospital Transport of Critically Ill Patients: A Multicenter, Prospective, Observational Study (I-TOUCH Study). Indian J Crit Care Med 2023; 27 (9):635-641.
Background: Critically ill patients are frequently transported to various locations within the hospital for diagnostic and therapeutic purposes, which increases the risk of adverse events (AEs). This multicenter prospective observational study was undertaken to determine the incidence of AEs related to intrahospital transport, their severity, and their effects on patient outcomes.
Patients and methods: We included consecutive unstable critically ill patients requiring intrahospital transport, across 15 Indian tertiary care centers over 5 months (October 11, 2022–February 20, 2023). Apart from the demographics and severity of illness, data related to transport itself, such as indications and destination, incidence of AEs, their category and treatment required, and patient outcomes, were recorded in a standard form.
Results: Eight hundred and ninety-three patients were transported on 1065 occasions out of the intensive care unit (ICU). The mean (SD) acute physiology and chronic health evaluation II score of the patients was 15.38 (±7.35). One hundred and two AEs occurred, wherein cardiovascular instability was the most common occurrence (31, 30.4%). Two patients had cardiac arrest immediately after transport. Acute physiology and chronic health evaluation II [odds ratio (OR): 1.02, 95% confidence interval (CI) – 1.00–1.05, p = 0.04], emergent transport (OR: 5.11, 95% CI – 3.32–7.88, p = 0.00), and team composition (OR: 5.34, 95% CI – 1.63–17.5, p = 0.00) during transport were found to be independent predictors of AEs.
Conclusions: We found a high incidence of AEs during intrahospital transport of critically ill patients. These events were more common during emergent transports and when the patients were transported by doctors. Transport by itself was not related to ICU mortality. We feel that stabilization of the patients before transport and adherence to a standardized protocol may help in minimizing the AEs, thereby enhancing patient safety.
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