目的 总结评价并整合急危重症患者院间转运评估分级的最佳证据,为临床实践提供依据。方法 按照证据资源“6S”模型系统检索国内外专业指南网、协会网以及数据库中有关急危重症患者院间转运评估分级的指南、证据总结、系统评价、临床决策、最佳实践、专家共识,检索时限为建库至2024年1月3日。由循证小组进行文献质量评价及证据提取。结果 共纳入11篇文献,其中指南5篇、专家共识4篇、系统评价2篇,形成了5个类别的27条证据,包括实施评估及分级的人员、实施评估的工具、实施评估的时机、评估及分级的项目（病情评估、转运相关事项评估、风险评估、分级项目）、评估及分级的记录。结论 该研究总结了急危重症患者院间转运评估分级的最佳证据,为临床开展院间转运实践提供依据。
Objective To summarize and integrate the best evidence for assessment and classification of inter-hospital transport in critically ill patients,so as to provide references for clinical practice. Methods Guidelines,evidence summary,systematic review,clinical decision,best practice and expert consensus on the assessment and classification of inter-hospital transport of critically ill patients were systematically searched in professional guideline networks,association networks and databases at home and abroad according to the "6S" model of evidence resources. The retrieval time was from the establishment of the database to January 3,2024. The evidence-based group evaluated the quality of the literature and extracted evidence. Results A total of 11 articles were included,involving 5 guidelines,4 expert consensuses and 2 systematic reviews. Finally,27 pieces of best evidence were summarized from 5 categories,namely personnel,tools,timing,items（disease assessment,transport-related matters assessment,risk assessment,classification）,assessment and classification records. Conclusion This study summarizes the best evidence for the assessment and classification of inter-hospital transport in critically ill patients,so as to provide a basis for clinical development of inter-hospital transport.
[1] Tran QK,O'Connell F,Hakopian A,et al. Patient care during interfacility transport:a narrative review of managing diverse disease states[J]. World J Emerg Med,2023,14(1):3-9.
[2] 孙朋霞,李树亚,华小雪,等. 急危重症患者院间转运护理质量评价指标的构建[J]. 中华护理杂志,2023,58(15):1831-1837.
Sun PX,Li SY,Hua XX,et al.Construction of a nursing quality evaluation index system for inter-hospital transfer of emergency critically ill patients[J]. Chin J Nurs,2023,58(15):1831-1837.
[3] Eiding H,Kongsgaard UE,Braarud AC.Interhospital transport of critically ill patients:experiences and challenges,a qualitative study[J]. Scand J Trauma Resusc Emerg Med,2019,27(1):27.
[4] Registered Nurses' Association of Ontario.Transitions in care and services[EB/OL]. (2023-06-01)[2024-01-05]. https://rnao.ca/bpg/guidelines/transitions-in-care.
[5] Williams O.Inter-hospital transfers of critically ill patients:next-of-kin communication & documentation of reason for transfer:an observational audit[J]. J Inten Care Society,2023,24(1):28-29.
[6] 朱政,胡雁,邢唯杰,等. 不同类型循证问题的构成[J]. 护士进修杂志,2017,32(21):1991-1994.
Zhu Z,Hu Y,Xing WJ,et al.The composition of different types of evidence based problems[J]. J Nurses Train,2017,32(21):1991-1994.
[7] Dicenso A,Bayley L,Haynes RB.Accessing pre-appraised evidence:fine-tuning the 5S model into a 6S model[J]. Evid Based Nurs,2009,12(4):99-101.
[8] The AGREE Next Steps Consortium. Appraisal of guidelines for research & evaluation Ⅱ[EB/OL]. (2017-12-01)[2024-01-05]. https://www.agreetrust.org/wp-content/uploads/2017/12/AGREE-II-Users-Manual-and-23-item-Instrument-2009-Update-2017.pdf.
[9] JBI. Appendix 4.1:JBI critical appraisal checklist for text and opinion papers[EB/OL]. (2022-06-30)[2024-01-05].https://jbi-global-wiki.refined.site/space/MANUAL/4689546/Appendix+4.1%3A+JBI+Critical+Appraisal+Checklist+for+Text+and+Opinion+Papers.
[10] Shea BJ,Reeves BC,Wells G,et al.AMSTAR 2:a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions,or both[J]. BMJ,2017,358:j4008.
[11] 杨红燕,兰美娟,魏慧,等. 颈动脉支架植入术患者围手术期血压管理的最佳证据总结[J]. 中华急危重症护理杂志,2024,5(1):80-85.
Yang HY,Lan MJ,Wei H,et al.Summary of the best evidence for perioperative blood pressure management in carotid artery stenting patients[J]. Chin J Emerg Crit Care Nurs,2024, 5(1):80-85.
[12] JBI. Levels of evidence and grades of recommendation working party JBI levels of evidence[EB/OL]. (2020-06-01)[2024-01-15]. https://jbi.global/sites/default/files/2020-07/Supporting_Doc_JBI_Levels_of_Evidence.pdf.
[13] Hong Kong College of Anaesthesiologists.Guidelines for transport of the critically ill[EB/OL]. (2019-08-21)[2024-01-03].https://www.hkca.edu.hk/wp-content/uploads/2020/12/Resources-college_guideline-P9.pdf.
[14] Intensive Care Society. The transfer of the critically ill adult[EB/OL].(2019-01-01)[2024-01-03]. https://ics.ac.uk/resource/transfer-critically-adult.html.
[15] 中华医学会重症医学分会. 《中国重症患者转运指南(2010)》(草案)[J]. 中国危重病急救医学,2010,22(6):328-330.
Critical Care Medicine Branch of Chinese Medical Association. Chinese guidelines for the transport of critically ill patients,2010[J]. Chin Crit Care Med,2010,22(6):328-330.
[16] Warren J,Fromm RE Jr,Orr RA,et al.Guidelines for the inter-and intrahospital transport of critically ill patients[J]. Crit Care Med,2004,32(1):256-262.
[17] Staniszewska A,Gaba K,Patterson B,et al.Consensus statement on the interhospital transfer of patients with acute aortic syndrome:TRAVERSING Delphi study[J]. Emerg Med J,2024,41(3):153-161.
[18] 危重症患者院际转运专家共识组,国家急诊专业质控中心. 危重症患者院际转运专家共识[J]. 中华急诊医学杂志,2022,31(1):17-23.
Consensus Group of Experts on Inter-hospital Transport of Emergency Critical Patients,National Emergency Professional Quality Control Center.Expert consensus on inter-hospital transport of critically ill patients[J]. J Zhejiang Chin Med Univ,2022,31(1):17-23.
[19] 中国研究型医院协会卫生应急学专业委员会,中国中西医结合学会灾害医学专业委员会,广东省医学会急诊医学分会,等. 患者院外转运服务规范专家共识(2018)[J]. 中华卫生应急电子杂志,2018,4(4):193-203.
Health Emergency Committee of China Research Hospital As-sociation,Disaster Medicine Professional Committee of China Association of Traditional Chinese and Western Medicine,Emergency Medine Branch of Guangdong Medical Association,et al. Expert consensus on outpatient transport service specification(2018)[J]. Chin J Hyg Rescue Electron Ed,2018,4(4):193-203.
[20] 中国医师协会烧伤科医师分会,中华医学会烧伤外科学分会. 成批严重烧伤伤员的转运方案(2016版)[J]. 中华烧伤杂志,2016,32(8):449-451.
Burn Surgery Branch of Chinese Medical Doctor Association,Burn Surgery Branch of Chinese Medical Association.Transport scheme for batch of severe burn wounded(2016 edition)[J]. Chin J Burns,2016,32(8):449-451.
[21] Kikutani K,Shimatani T,Kawaguchi A,et al.Medical equipment that improve safety and outcomes of inter-facility transportation of critically ill patients:a systematic review[J]. Medicine,2023,102(22):e33865.
[22] Young E,Khoo TW,Trochsler MI,et al.Factors influencing interhospital transfer delays in emergency general surgery:a systematic review and narrative synthesis[J]. ANZ J Surg,2022,92(6):1314-1321.
[23] Mueller S,Murray M,Goralnick E,et al.Implementation of a standardised accept note to improve communication during inter-hospital transfer:a prospective cohort study[J]. BMJ Open Qual,2023,12(4):e002518.
[24] 李凡,孙朋霞,李树亚,等. 急诊危重症患者院间转运现状的横断面调查研究[J]. 中国急救医学,2022,42(2):132-136.
Li F,Sun PX,Li SY,et al.A cross-sectional survey of the current status of interhospital transfer for critically ill patients[J]. Chin J Crit Care Med,2022,42(2):132-136.
[25] Usher M,Sahni N,Herrigel D,et al.Diagnostic discordance,health information exchange,and inter-hospital transfer outcomes:a population study[J]. J Gen Intern Med,2018,33(9):1447-1453.
[26] Heincelman M.Implementation of a physician accept note to improve interhospital transfer documentation on general medi-cine services:A quality improvement(QI) project[J]. J Gen Inter Med,2020,35(SUPPL 1):S168.
