The Safety and Efficacy of High-Speed Train Transportation for Critically Ill Children: A Retrospective Propensity Score Matching, Cohort Study

Abstract

Background: With the tremendous development of high-speed train (HST) network in China, HST medical transportation gradually surfaced and developed an alternative approach of long-distance medical transportation for critically ill patients. However, its safety and efficiency have not been well defined. We hypothesized that HST transportation is much more efficient and economical than the traditional land ambulance for long-distance transportation. Methods: This single-center, retrospective cohort study involved all patients transported to a tertiary medical center from June 01, 2016, to June 30, 2019. All the patients were classified into two groups: HST group, and ambulance group. The propensity score matching method was performed for the comparison between the groups. The primary outcome was hospital mortality. Secondary outcomes included duration of transportation, transportation cost, hospital stay, and hospitalization cost. Findings: A total of 509 critically ill children were transported and admitted; 40 were transported by HST, and the remaining 469 patients by ambulance. The transportation distance in the HST group was longer than that in the ambulance group (1894.5±907.09 vs. 902.66±735.74, p 0.05). There was no death report during transportation for all children. There was no difference between the groups regarding the transportation cost, hospital stays, and hospitalization cost (all p > 0.05). Interpretation: HST transportation network could be a promising approach to transport critically ill children in China and other countries, where an HST network has been well developed. Funding Statement: This study was supported by Capital Funds for Health Improvement and Research (2020-2-5093). Declaration of Interests: The authors have no conflicts of interest to disclose. Ethics Approval Statement: The study was approved by the Ethics Committee of the People’s Liberation Army general hospital (No.2016-039), and registered in ChiCTR (ChiCTR2000032306). Written consent was obtained from the parents or guardians. The methodology in this study was in accordance with the relevant guidelines and regulations.