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Am J Perinatol 2013; 30(05): 377-382
DOI: 10.1055/s-0032-1324706
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Variations in Transport Outcomes of Outborn Infants among Canadian Neonatal Intensive Care Units

Sabrina H.Y. Eliason
1   University of British Columbia, Vancouver, British Columbia, Canada
,
Hilary Whyte
2   Department of Paediatrics, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada
,
Kim Dow
3   Department of Paediatrics, Queen's University, Kingston, Ontario, Canada
,
Catherine M. Cronin
4   Interior Health, Medical Affairs and Clinical Networks, Kelowna, British Columbia, Canada
,
Shoo Lee
5   Department of Pediatrics, Mount Sinai Hospital, University of Toronto, Toronto, Canada
,
Canadian Neonatal Network › Author Affiliations
Further Information

Publication History

31 March 2012

22 May 2012

Publication Date:
23 August 2012 (online)

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Abstract

Background Outborn infants born at community hospitals and transported to tertiary neonatal intensive care units (NICUs) for treatment account for 20% of all tertiary NICU admissions in Canada. Little is known about variations in their outcomes. The Transport Risk Index of Physiologic Stability (TRIPS) is a validated score of neonatal physiological status that can identify differences between transport teams' outcomes.

Objective To examine regional variations in outcomes among outborn infants transported to Canadian tertiary NICUs using TRIPS.

Design and Methods Transport teams prospectively collected data for all outborn infants admitted to 25 Canadian NICUs during 2006 to 2007. Singleton outborn infants ≥ 32 weeks' gestation admitted to NICUs for at least 24 hours who died or who were transferred to another NICU within 24 hours were examined for overall incidence of mortality, major morbidity, and change in TRIPS score.

Results Complete transport data were available for 2313 (72.9%) of 3193 eligible infants. There were significant variations in interhospital and interprovincial outcomes. Factors significantly affecting change in TRIPS score were gender, pretransport TRIPS score, composition of transport team and distance traveled.

Conclusion Significant variation exists in transport outcomes in Canada. Further investigation is required to optimize infant transport systems, processes, and clinical care.

Keywords

neonatal intensive care - health transport system - Canadian Health Care
 

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