Analysis of Interhospital Transfer of Critically Ill Patients to the Coronary Care Unit of a Highly Complex Hospital

Background: Interhospital transfer of critically ill patients is frequent in our country. However, despite the existence of emergency medical transfer services both in public and private settings, no scientific publications have been generated regarding the transfer of critically ill patients to understand their operation, planning and results. Objective: The aim of this study was to describe the conditions of interhospital transfer of cardiovascular disease patients. Methods: This was an observational, prospective, multicenter design study, analyzing interhospital land transfer of patients admitted to a third level coronary care unit between April 2014 and April 2015. The transfer physician was surveyed. Complications related to hospital transfer and mortality were also recorded. Results: A total of 214 transfers were analyzed. Median transfer time was 30 minutes (IQR 18.5-50). Among all transfers, 16.1% of cases were considered to be at high risk, 71.2% at moderate risk and 12.7% at low risk, according to a validated score. The main diagnoses were acute coronary syndrome (66.8%), heart failure (8.9%) and bradyarrhythmia or blockade (3.7%). In 73.5% of highrisk transfers, high complexity ambulances were used, and in low- and moderate-risk transfers (30.8% and 28.9%, respectively), they were carried out with low complexity ambulances. Fifty percent of transfers were performed by resident physicians; 10.8% of cases presented with some complication during the transfer and/or during the first hour. Complications were more frequent in high-risk transfers and were associated with in-hospital mortality. There was no association between estimated increased risk of transfer and greater ambulance complexity (p=0.6). Conclusion: Transfer scheduling was not adequate. The calculated risk of transfers was predominantly low, with a high proportion of severe complications, which impacted in in-hospital mortality. Introducción: Los traslados interhospitalarios de pacientes críticos son frecuentes en nuestro medio; sin embargo, a pesar de la existencia de servicios de traslados médicos de emergencia tanto en el ámbito público como privado, no se han generado publicaciones científicas relacionadas con traslado de pacientes críticos que permitan conocer su funcionamiento, planificación y resultados. Objetivo: Describir las condiciones de traslado interhospitalario de pacientes con patología cardiovascular. Material y métodos: Estudio de diseño observacional, prospectivo, mul