title: Delayed medical emergency team calls and associated outcomes.
abstract: OBJECTIVE
  To determine whether there was an association between delayed medical emergency team calls and mortality after a medical emergency team review.
  
  
  METHODS
  This was a prospective observational study.
  
  
  METHODS
  A university-affiliated tertiary referral hospital in Porto Alegre, Brazil.
  
  
  METHODS
  All patients were reviewed by the medical emergency team from July 2008 to December 2009.
  
  
  METHODS
  None.
  
  
  RESULTS
  There were 1,481 calls for 1,148 patients. Delayed medical emergency team calls occurred for 246 patients (21.4%). The criterion associated with delay was typically the same criterion for the subsequent medical emergency team call. Physicians had a greater prevalence of delayed medical emergency team calls (110 of 246 [44.7%]) than timely medical emergency team calls (267 of 902 [29.6%]; p < 0.001). The mortality at 30 days after medical emergency team review was higher among patients with delayed medical emergency team activation (152 [61.8%]) than patients receiving timely medical emergency team activation (378 [41.9%]; p < 0.001). In a multivariate analysis, delayed medical emergency team calls remained significantly associated with higher mortality.
  
  
  CONCLUSIONS
  Delayed medical emergency team calls are common and are independently associated with higher mortality. This result reaffirms the concept and need for a rapid response system.
authors.affiliation: 1Critical Care Department, Hospital Nossa Senhora da Conceição, Porto Alegre, Rio Grande do Sul, Brazil. 2Critical Care Department, Santa Casa de Misericórdia, Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Márcio M
authors.initials: MM
authors.lastname: Boniatti
authors.forename: Neusa
authors.initials: N
authors.lastname: Azzolini
authors.forename: Marina V
authors.initials: MV
authors.lastname: Viana
authors.forename: Berenice S P
authors.initials: BS
authors.lastname: Ribeiro
authors.forename: Renata S
authors.initials: RS
authors.lastname: Coelho
authors.forename: Rodrigo K
authors.initials: RK
authors.lastname: Castilho
authors.forename: Márcio R
authors.initials: MR
authors.lastname: Guimarães
authors.forename: Lia
authors.initials: L
authors.lastname: Zorzi
authors.forename: Luis F
authors.initials: LF
authors.lastname: Schulz
authors.forename: Edison M Rodrigues
authors.initials: EM
authors.lastname: Filho
mesh_terms: D001938:Brazil; D057210:Delayed Diagnosis / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D057209:Hospital Rapid Response Team / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors