Clinical outcomes of critically ill infants requiring interhospital transport to a paediatric tertiary centre in Hong Kong

Abstract

Background: Specialised transport teams are associated with fewer complications during interhospital transport. Such teams are currently unavailable in Hong Kong. The aim of this study was to review the clinical outcomes of critically ill infants requiring interhospital transport in Hong Kong. Methods: We retrospectively reviewed the characteristics and clinical outcomes of all infants transported from the neonatal units of regional or private hospitals into the neonatal or cardiac intensive care unit (ICU) of Queen Mary Hospital, a tertiary-wide academic centre in Hong Kong from 1st August 2013 to 31st July 2016. Results: A total of 256 infants with a mean gestational age of 31.7 ± 5.5 weeks and birth weight of 1732 ± 1007 g were included in the study. While 143 (55.9%) patients were intubated during transport, there was no documentation of close monitoring of physiological parameters for 91.4% of the patients. Close to half of the patients (44.1%) had complications on admission and 23.4% required significant interventions immediately after the transfer. The median length of stay in the ICU was 3.3 (range: 0.5–342.6) days. Five patients died of non-transport-related causes within 7 days of admission. Multiple logistic regression analysis showed that intubated patient (P = 0.001) or patient requiring inotropic support during transport (P = 0.027) were more likely to develop complications. Higher birth weight (P = 0.022) and younger chronological age at transfer (P = 0.030) were also significant risk factors for complications. Conclusions: Complications and interventions are considerable during interhospital neonatal transport in Hong Kong. The complication rate was higher than medical infrastructures that provided a specialised team for this process. Documentation during transport was inadequate.