Reasons for Repeat Rapid Response Team Calls, and Associations with In-Hospital Mortality.
Jt Comm J Qual Patient Saf
; 45(4): 268-275, 2019 Apr.
Article
em En
| MEDLINE
| ID: mdl-30522833
ABSTRACT
BACKGROUND:
Previous publications noted increased mortality risk in patients subject to repeat rapid response team (RRT) calls. These patients were examined as a homogenous group, but there may be many reasons for repeat calls. Those potentially preventable by the rapid response system have not been investigated.METHODS:
In a retrospective cohort study, patients with potentially preventable repeat calls were classified into two categories type 1 (patients who had a repeat call following an initial call that ended despite the patient still triggering RRT calling criteria [T1-PRC]) and type 2 (patients with a repeat call within 24 hours of an initial call and for the same reason [T2-PRC]). In-hospital mortality for these patients and for those with repeat calls for all other reasons (ORC) were compared to patients with only a single call during their admission (SC).RESULTS:
Mortality occurred in 31 (43.7%) T1-PRC, 13 (15.1%) T2-PRC, 56 (28.9%) ORC, and 289 (13.9%) SC patients. Univariate odds ratios (ORs), in comparison to SC patients, were 4.81 (95% confidence interval [CI] 2.96-7.81; p < 0.001), 1.10 (95% CI 0.60-2.02; pâ¯=â¯0.75), and 2.52 (95% CI 1.80-3.52; p < 0.001), respectively. Mortality effects persisted for the T1-PRC and ORC groups after adjustment for patient, admission, and initial call characteristics with ORs of 4.07 (95% CI 2.36-7.01; p < 0.001) and 2.29 (95% CI 1.57-3.34; p < 0.001), respectively.CONCLUSION:
This study found that repeat calls following an initial call that ended with ongoing breach of predefined calling criteria were strongly associated with increased mortality. This highlights the risk to patients when the RRT leaves reversible clinical deterioration unresolved at the end of a call.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Mortalidade Hospitalar
/
Equipe de Respostas Rápidas de Hospitais
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
Oceania
Idioma:
En
Revista:
Jt Comm J Qual Patient Saf
Assunto da revista:
SERVICOS DE SAUDE
Ano de publicação:
2019
Tipo de documento:
Article