Assessing Pediatric Inter-Hospital Transfer: A single-center, Retrospective, Observational Study of Saudi Arabia's National Life-Saving Protocol.
Assessing Pediatric Inter-Hospital Transfer: A single-center, Retrospective, Observational Study of Saudi Arabia's National Life-Saving Protocol.
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评估小儿院间转移：对沙特阿拉伯国家挽救生命方案的单一中心，回顾性，观察性研究。
DOI：
10.26502/jppch.74050130
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发表时间：
2022
期刊：
影响因子：
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中科院分区：
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检查我们国家救生协议 (LSP) 的准确性。据我们所知，这是沙特阿拉伯第一项针对这一问题的研究。 LSP 的创建是为了帮助在大型地区医院提供有限服务的外围医院对患有 LIFE 或 LIMB 威胁状况的患者进行分类，以获得明确的护理。这是一项为期 12 个月的回顾性单中心观察研究，研究了通过 LSP 到达我们唯一一家地区儿科医院急诊室 (ED) 的患者。对于通过 LSP 入住 PICU 的患者亚组，我们通过与通过其他途径而非 LSP 入住我们 PICU 的类似患者进行 1:1 匹配的病例对照研究，进一步评估了其死亡率和住院时间 (LOS) 等结局。主要结果是评估 LSP 对患有 LIFE of LIMB 状况的儿科患者进行分类的准确性。次要结局包括评估通过 LSP 入住地区 PICU 的患者与通过其他入院途径入住 PICU 的患者相比，LSP 与（死亡率，LOS）之间的关系。在研究期间，118 名患者通过 LSP 到达我们的急诊室。只有 43 名患者 (36%) 因 LIFE 或 LIMB 状况被送入 PICU。共有 64 名患者 (54%) 由于不存在 LIMB 威胁生命的情况而从急诊科直接转入普通儿科病房，8% (n=9) 由于没有任何重大疾病而立即从急诊科出院回家。一名患者在急诊室死亡，一名患者因骨科轻微受伤被转诊至另一家医院。对于通过LSP入住PICU的患者，死亡率为（13.9%）（6/43），对照组为（4.6%）（2/43），p值为0.08。 LSP 是我们医疗保健系统中的一项出色举措和重要工具；然而，我们的研究表明，系统识别真正患有 LIFE 或 LIMB 疾病的儿科患者的能力存在巨大差异。我们的研究可能会成为未来评估国家层面 LSP 的研究的基石。
To examine the accuracy of our national Life-Saving Protocol (LSP). To the best of our knowledge, this is the first study addressing this issue in Saudi Arabia. LSP was created to facilitate triaging patients with LIFE or LIMB threatening conditions in peripheral hospitals with limited services to large regional hospitals to receive definitive care. This is a retrospective single-center observational study over 12 months studying the patients who arrived via LSP to our Emergency room (ED), at the only regional pediatric hospital. For the subgroup of patients who were admitted to PICU through LSP, we further assessed their outcomes like mortality and length of stay (LOS) through a matched case-control study of 1:1 with similar patients who were admitted to our PICU via other routes rather than LSP. The primary outcome is to assess the accuracy of the LSP in triaging pediatric patients with LIFE of LIMB conditions. Secondary outcomes include assessing the association between LSP and (mortality, LOS) for those who were admitted to the regional PICU via LSP compared to patients admitted to PICU via other sources of admission. During the study period, 118 patients arrived at our ED via LSP. Only 43 patients (36 %) were admitted to the PICU with LIFE or LIMB conditions. A total of 64 patients (54%) of the patients were admitted directly to the general pediatric ward from ED level due to absence of LIFE of LIMB threatening condition and 8% (n=9) were discharged immediately home from the ED level due to lack of any significant illness. One patient died at ED level, and one was referred to another hospital with a minor orthopedic injury. For those who were admitted to the PICU via LSP, the mortality rate was (13.9%) (6/43), and the control group was (4.6%) (2/43) with a p-value of 0.08. LSP is an excellent initiative and essential tool in our healthcare system; however, our study showed huge variation in the ability of the system to recognize true pediatric patients with LIFE or LIMB conditions. Our study might form a stepping-stone in future studies assessing the LSP at the national level.