Early prognostic value of the medical emergency team calling criteria in patients admitted to intensive care from the emergency department.
OBJECTIVE
To evaluate the early prognostic value of the medical emergency team (MET) calling criteria in patients admitted to intensive care from the emergency department.


METHODS
Retrospective cohort study.


METHODS
Emergency department and department of intensive care medicine of a 960-bed tertiary referral hospital.


METHODS
A total of 452 consecutive adult patients admitted to intensive care from the emergency department from January 1, 2004, to December 31, 2004.


METHODS
None.


RESULTS
MET calling criteria were retrospectively extracted from patient records, and the sum of positive criteria was calculated for the first hour in the emergency department (METinitial) and subsequently until admission to the intensive care unit in a series of time periods. The maximum number of positive MET calling criteria during any time period was defined (METmax). Logistic regression analysis revealed METinitial (odds ratio [OR] 3.392, 95% confidence interval [CI] 2.534-4.540) and METmax (OR 3.867, 95% CI 2.816-5.312) to be significant predictors of hospital mortality, the need for mechanical ventilation (METinitial: OR 4.151, 95% CI 3.53-4.652; METmax: OR 4.292, 95% CI 3.151-5.846), and occurrence of hemodynamic instability (METinitial: OR 1.548, 95% CI 1.258-1.905; METmax: OR 1.685, 95% CI 1.355-2.094) (all p < .0001).


CONCLUSIONS
MET scores collected early after admission or throughout the stay in the emergency department allow for simple identification of patients at risk of unfavorable outcome during the subsequent intensive care unit stay.
Etter
Reto
R
Department of Intensive Care Medicine, University Hospital Bern, University of Bern, Bern, Switzerland.
Ludwig
Roger
R
Lersch
Friedrich
F
Takala
Jukka
J
Merz
Tobias M
TM
D016638:Critical Illness / Q000628:therapy*; D004636:Emergency Service, Hospital / Q000592:standards*; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000592:standards*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors