Features and outcome of patients receiving multiple Medical Emergency Team reviews.
OBJECTIVE
There is no information on the clinical features and outcome of patients receiving multiple Medical Emergency Team (MET) reviews. Accordingly, we studied the characteristics and outcome of patients receiving one MET call and compared them with those receiving multiple MET reviews.


METHODS
Retrospective observational study using prospectively collected data.


METHODS
Tertiary hospital.


METHODS
Cohort of 1664 patients receiving 2237 MET reviews over a 2-year period.


RESULTS
We retrieved information about patient demographics, reasons for MET review, procedures performed by the MET and hospital outcome. We found that 1290 (77.5%) patients received a single MET review and 374 (22.5%) received multiple MET reviews (mean 2.5 reviews, median 2.0). Multiple MET reviews were more likely to be in surgical patients (p < 0.001) and to be due to arrhythmias (p = 0.016). Multiple MET review patients were more likely to be admitted for gastrointestinal diseases (p < 0.001), had a 50% longer hospital stay (p < 0.001) and a 34.6% increase in hospital mortality (p < 0.001) compared to single MET review patients. Their odds ratio (OR) for mortality was 2.14 (95% C.I.: 1.62-2.83; p < 0.001). After exclusion of patients with not for resuscitation (NFR) orders, the OR for mortality was 2.92 (95% C.I.: 2.10-4.06; p < 0.001). The in-hospital mortality of patients subject to multiple MET reviews who were not designated NFR was 34.1%, but only 9.7% of these deaths occurred within 48 h of the initial MET review.


CONCLUSIONS
In our hospital, one fifth of patients receiving MET calls are subject to multiple MET calls. Such patients have identifiable features and have an increased risk of morbidity and mortality. Within any rapid response system, such patients should be recognized as a higher risk group and receive specific additional attention.
Calzavacca
Paolo
P
Department of Intensive Care, Austin Hospital, Melbourne, Australia. paolo.calzavacca@austin.org.au
Licari
Elisa
E
Tee
Augustine
A
Mercer
Inga
I
Haase
Michael
M
Haase-Fielitz
Anja
A
Jones
Daryl
D
Gutteridge
Geoff
G
Bellomo
Rinaldo
R
D000368:Aged; D016009:Chi-Square Distribution; D004638:Emergency Treatment / Q000592:standards*; D005260:Female; D017052:Hospital Mortality; D057209:Hospital Rapid Response Team / Q000458:organization & administration*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013577:Syndrome; D016896:Treatment Outcome; D055986:Vital Signs