Skip to main content

Advertisement

Volume 3 Supplement 1

ESICM LIVES 2015

Outcomes following repatriation from cardiothoracic intensive care to referring centres

Article metrics

  • 258 Accesses

Introduction

Appropriate repatriation of patients from specialist ICUs back to a referring unit is essential to maintain access to specialist services. Currently, this represents a small proportion of interhospital critical care transfers in the UK though trends towards increased regionalisation of specialist services is a potential driver for increases in such transfers.

Objectives

To assess mortality and discharge destination of patients following transfer from Papworth Cardiothoracic Intensive Care Unit to referring hospitals. This includes patients receiving cardiothoracic surgery and those referred for Extracorporeal Membrane Oxygenation (ECMO).

Methods

Retrospective analysis of Papworth ICU ICNARC data (Intensive Care National Audit and Research Centre) and ICU Computer Information System data from April 2012-April 2014.

Results

169 patients were transferred from Papworth ICU to a general ICU during the study period. 46 (27.2%) were originally referred for ECMO, 123 (72.8%) in the non-ECMO group were predominantly elective & emergency cardiothoracic surgery patients.

The overall median Length of Stay (LoS) in Papworth ICU was 11 days (Interquartile range, IQR, 15.5 days). In the receiving hospital, median LoS was 18 days (IQR 28.5 days) for the ECMO group and 12 (IQR 28.5) days for the Non-ECMO group.

63% of patients survived to be discharged home from the receiving centre across both ECMO & non-ECMO groups. A further 13% and 11.4% respectively of patients were discharged to a rehabilitation facility (either short or long-term). 8 of 46 ECMO patients (16.7%) died following transfer from Papworth ICU to referring centre, 28 of 123 non-ECMO patients died after transfer (22.8%).

Conclusions

The majority of patients referred for specialist cardiothoracic services over the study period, including ECMO, survived to be discharged home, despite representing a population of relatively prolonged ICU & hospital stay. Repatriation from our centre to referring general ICUs is generally safe & appropriate though there is likely scope for improvement in the efficiency and safety of such transfers. Future research in this area could assess methods for quality assurance and scope for standardisation.

References

  1. 1.

    The Intensive Care Society: Guidelines for the transport of critically ill patients. 2011, London

  2. 2.

    Hains IM, Marks A, Georgiou A, et al: Non-emergency patient transport: what are the quality and safety issues? A systematic review. Int J Qual Safety Health Care. 2010, 1-8.

Download references

Author information

Correspondence to N Abu Al-Saad.

Rights and permissions

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0), which permits use, duplication, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Abu Al-Saad, N., Burton, J., Jones, N. et al. Outcomes following repatriation from cardiothoracic intensive care to referring centres. ICMx 3, A160 (2015) doi:10.1186/2197-425X-3-S1-A160

Download citation

Keywords

  • Extracorporeal Membrane Oxygenation
  • Discharge Destination
  • ECMO Patient
  • General ICUs
  • Computer Information System