Evidence map›Paper›PMID 33941116›Full record

ArticleBMC pediatrics2021

The effect of care provided by paediatric critical care transport teams on mortality of children transported to paediatric intensive care units in England and Wales: a retrospective cohort study.

Sarah E Seaton, Elizabeth S Draper, Christina Pagel, Fatemah Rajah, Jo Wray, Padmanabhan Ramnarayan, DEPICT Study Team

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC pediatrics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03520192 (Critically Ill Children and Young People), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.5field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03520192 completednot on this map

Critically Ill Children and Young People: do National Differences in

TypeobservationalSponsorGreat Ormond Street Hospital for Children NHS Foundation TrustRan2019 to 2021Enrolled2,838ConditionsAccess and Transport to Paediatric Intensive Care
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Sarah E SeatonDepartment of Health Sciences, University of Leicester, Leicester, LE1 7RH, UK. sarah.seaton@leicester.ac.uk.
Elizabeth S DraperDepartment of Health Sciences, University of Leicester, Leicester, LE1 7RH, UK.
Christina PagelClinical Operational Research Unit, University College London, London, UK.
Fatemah RajahYorkshire and Humber Infant and Children's Transport Service (Embrace), Barnsley, UK.
Jo WrayHeart and Lung Directorate, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
Padmanabhan RamnarayanChildren's Acute Transport Service (CATS), Great Ormond Street Hospital NHS Foundation Trust, London, UK.
DEPICT Study Team
Great Ormond Street Hospital for Children NHS Foundation Trust · GBUniversity of Leicester · GBUniversity College London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCentralisation of paediatric intensive care units (PICUs) has the increased the need for specialist paediatric critical care transport teams (PCCT) to transport critically ill children to PICU. We investigated the impact of care provided by PCCTs for children on mortality and other clinically important outcomes.

methodsWe analysed linked national data from the Paediatric Intensive Care Audit Network (PICANet) from children admitted to PICUs in England and Wales (2014-2016) to assess the impact of who led the child's transport, whether prolonged stabilisation by the PCCT was detrimental and the impact of critical incidents during transport on patient outcome. We used logistic regression models to estimate the adjusted odds and probability of mortality within 30 days of admission to PICU (primary outcome) and negative binomial models to investigate length of stay (LOS) and length of invasive ventilation (LOV).

resultsThe study included 9112 children transported to PICU. The most common diagnosis was respiratory problems; junior doctors led the PCCT in just over half of all transports; and the 30-day mortality was 7.1%. Transports led by Advanced Nurse Practitioners and Junior Doctors had similar outcomes (adjusted mortality ANP: 0.035 versus Junior Doctor: 0.038). Prolonged stabilisation by the PCCT was possibly associated with increased mortality (0.059, 95% CI: 0.040 to 0.079 versus short stabilisation 0.044, 95% CI: 0.039 to 0.048). Critical incidents involving the child increased the adjusted odds of mortality within 30 days (odds ratio: 3.07).

conclusionsVariations in team composition between PCCTs appear to have little effect on patient outcomes. We believe differences in stabilisation approaches are due to residual confounding. Our finding that critical incidents were associated with worse outcomes indicates that safety during critical care transport is an important area for future quality improvement work.

Indexed as

Critical CareIntensive Care Units, PediatricChildCritical IllnessEnglandHumansInfantRetrospective StudiesWalesCritical care transportPaediatric intensive carePaediatric transport

Identifiers

PMID33941116
PMCPMC8089132
OpenAlexW3159342123

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.