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The Canadian Paediatric Triage and Acuity Scale algorithm for interfacility transport

Tanya Holt, MD, Michael Prodanuk, BSc, Gregory Hansen, MD, MPH, MSc

Abstract


Objective: Determining pediatric severity of illness in referring centers may be useful for establishing appropriate patient disposition and interfacility transport. For this retrospective review, the authors evaluated the Canadian Paediatric Triage and Acuity Scale (PaedCTAS) tool in regards to individual patient disposition and outcomes.

Methods: A disposition score using the PaedCTAS algorithm was retrospectively calculated from referring center data at the time our transport team was consulted. Data included children < 17 years transported to our tertiary pediatric center between April 2013 and March 2014. Patients were excluded if transported because of elective or planned interventions, investigations, and/or treatment.

Results: A total of 194 pediatric patients were identified, with 49 requiring a pediatric intensive care unit (PICU) admission. A PaedCTAS assessment of 1 was the only transport characteristic evaluated that was significantly associated (odds ratio [OR] 6.15; p < 0.0001) with PICU admissions, with an area under the receiver-operating characteristic curve of 0.72 (95% CI 0.64, 0.77). On multivariate analysis, a PaedCTAS assessment of 1 was also associated with a length of hospital stay greater than 3 days (OR 1.81; 95% CI 0.99, 3.31; p = 0.05).

Conclusions: A PaedCTAS assessment of 1 may be a reasonable predictor for PICU admissions and longer hospitalizations when calculated in referral centers at time of pediatric transport consultation. PaedCTAS assessments may provide useful adjuvant information for specialized pediatric transport programs.


Keywords


patient transfer, pediatrics, severity of illness index, triage

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References


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DOI: http://dx.doi.org/10.5055/ajdm.2018.0282

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