A. Hackel, R. Wong, P. Sunshine
Apr 1, 1981
Previous studies have demonstrated the effect on outcome of critically ill newborn infants transported from community hospitals to regional ICNs. The effect of transport variables has not been studied on a standardized population. Requirements for such a study include a “one disease” population, a “controlled” pre-transport severity of illness and an adequate number of cases to allow for multivariate analysis. A population meeting these requirements composed of 335 infants with RDS transported in 1977 to 10 No. Calif. ICNs was studied. Transport teams arrived in the referral hospital in the first 12 hours of life. The RDS diagnosis was made at the ICNs. Outcome was measured as survival at ICN discharge. Infants with birthweights between 750 and 2500 grams were included. The severity of illness was controlled by fitting basic pre-transport physiologic and therapeutic variables to a multiple logistic function. Pre-transport variables included birthweight, 5 minute Apgar, pH, temperature, and tracheal intubation. When the pre-transport population was standardized, the influence of transport team response time and patient transit time on survival was found to be insignificant. The transport mode was significant. Infants transported by air had a 96% survival rate versus 78% for those transferred by surface. The transport variables studied did not effect patient outcome; the exception being transport mode. Further studies are required to determine the cause of this difference.