Critically ill patients undergoing interhospital transportation: a prospective multicentre cohort study in the Euregio Meuse-Rhine

Abstract

Objective: The principal aim of this study was to investigate differences in the characteristics and physiological parameters of critically ill patients who underwent interhospital transportation.

Design: Prospective observational cohort study.

Setting: Multicentre study within the Euregio Meuse-Rhine, including Dutch and German hospitals.

Patients: A representative sample of critically ill adult patients who underwent interhospital transport accompanied by a physician was included.

Interventions: None.

Transportation cohort description: Data on patient characteristics, transport logistics, interventions and adverse events were recorded using an online questionnaire. The cohort was divided into Dutch and German subsets and further stratified based on the transportation modality. Descriptive statistics were utilised to present the cohort characteristics.

Results: Dutch patients (89%) were mainly transported by mobile intensive care unit (MICU). For the present investigation, in Germany, the Intensivtransportwagen was included in this MICU category, whereas German patients (48%) were mainly transported by intensive care ambulance (ICA). An intensivist accompanied most transports in the Netherlands, whereas various specialists transported patients in Germany. Interventions were primarily performed in the MICU for Dutch patients and in the ICA for German patients. Adverse events were reported in 5% of the cases.

Conclusions: These comprehensive data provide insights into the transportation differences of critically ill patients. This serves as a foundation for future investigations concerning the quality and efficacy of interhospital transportation.

Trial registration number: This study was registered in the Dutch National Trial Registration (NTR4937).

Keywords: Adult intensive & critical care; INTENSIVE & CRITICAL CARE; Quality in health care.

Figure 1. Transported population and transport modalities.

Figure 2. Transport times, example of an interhospital transport of an intensive care patient, transported by MICU from University Hospital Aachen (UKA) to Maastricht University Medical Centre+ (MUMC+). (1) MUMC+, collect MICU team; (2) UKA, the dispatching hospital; (3) MUMC+, the receiving hospital. (A) Total transport time: the interval between the departure of the MICU at the ambulance post and departure of the MICU after handover at MUMC+. (B) Arrival time: the interval between the departure of the MICU from MUMC+ with the MICU team and arrival at UKA. (C) Stabilisation time: the interval between the arrival at UKA and departure from UKA with the patient. (D) Patient transport time: the interval between the departure from UKA and arrival at MUMC+.