title: Characteristics and outcomes of patients requiring rapid response system activation within hours of emergency admission.
abstract: OBJECTIVE
  To establish the prevalence of emergency responses for clinical deterioration (cardiac arrest team or medical emergency team [MET] activation) within 24 hours of emergency admission, and determine if there were differences in characteristics and outcomes of ward patients whose emergency response was within, or beyond, 24 hours of emergency admission.
  
  
  METHODS
  A retrospective, descriptive, exploratory study using MET, cardiac arrest, emergency department and inpatient databases, set in a 365-bed urban district hospital in Melbourne, Australia. Participants were adult hospital inpatients admitted to a medical or surgical ward via the emergency department (ED) who needed an emergency response for clinical deterioration during 2012.
  
  
  METHODS
  Inhospital mortality, unplanned intensive care unit admission and hospital length of stay (LOS).
  
  
  RESULTS
  A total of 819 patients needed an emergency response for clinical deterioration: 587 patients were admitted via the ED and 28.4% of emergency responses occurred within 24 hours of emergency admission. Patients whose first emergency response was within 24 hours of emergency admission (compared with beyond 24 hours) were more likely to be triaged to Australasian triage scale category 1 (5.4% v 1.2%, P=0.005), less likely to require ICU admission after the emergency response (7.6% v 13.9%, P=0.039), less likely to have recurrent emergency responses during their hospital stay (9.7% v 34%, P < 0.001) and had a shorter median hospital LOS (7 days v 11 days, P < 0.001).
  
  
  CONCLUSIONS
  One-quarter of emergency responses after admission via the ED occurred within 24 hours. Further research is needed to understand the predictors of deterioration in patients needing emergency admission.
authors.affiliation: Nursing and Midwifery Research Centre, Eastern Health and Deakin University, Melbourne, VIC, Australia. julie.considine@deakin.edu.au.
authors.forename: Julie
authors.initials: J
authors.lastname: Considine
authors.affiliation: Intensive Care Unit, Box Hill Hospital, Eastern Health, Melbourne, VIC, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Charlesworth
authors.affiliation: School of Nursing and Midwifery, Deakin University, Melbourne, VIC, Australia.
authors.forename: Judy
authors.initials: J
authors.lastname: Currey
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital; D005260:Female; D017052:Hospital Mortality; D057209:Hospital Rapid Response Team; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D010343:Patient Admission; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome