Intensive care unit admission in patients following rapid response team activation: call factors, patient characteristics and hospital outcomes.
Rapid Response Systems (RRSs) have been widely introduced throughout hospital health systems, yet there is limited research on the characteristics and outcomes of patients admitted to an intensive care unit (ICU) following RRS activation. Using database extraction, this study examined the factors associated with ICU admission and patient outcome in patients receiving RRS activation in a tertiary level hospital between 2009 and 2013. Of 3004 RRS activations, 392 resulted in ICU admissions. Call factors associated with ICU admission and increased hospital mortality included tachypnoea (P <0.001 and P <0.001, respectively), hypoxia (P <0.001 and P <0.001, respectively) and having multiple Medical Emergency Team call triggers breached simultaneously (P <0.001 and P <0.001, respectively). Patients with seizures (P <0.001) and tachycardia (P=0.004) were more likely to survive to hospital discharge. Patient factors associated with ICU admission included young age (P <0.001) and having severe liver disease (P <0.001). Factors associated with increased hospital mortality included delayed RRS activation (P <0.001), increased age (P <0.001) and comorbidities including ischaemic heart disease (P=0.006), congestive heart failure (P <0.001), chronic kidney disease (P <0.001) and severe liver disease (P <0.001). Multiple factors relating to both the nature of the RRS activation call and patient characteristics are associated with ICU admission and hospital mortality post RRS activation. This information may be useful for risk stratification of deteriorating patients and determination of appropriate escalation.
Intensive Care Unit, St Vincent's Hospital, Melbourne, Victoria.
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MP
Le Guen
Intensive Care Unit, St Vincent's Hospital, Melbourne, Victoria.
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AE
Tobin
Intensive Care Unit, St Vincent's Hospital, Melbourne, Victoria.
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Reid
D000367:Age Factors; D000368:Aged; D001315:Australia; D005260:Female; D017052:Hospital Mortality; D057209:Hospital Rapid Response Team / Q000458:organization & administration / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data*; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis
adult; intensive care; medical emergency team; mortality; rapid response team