title: Failure to activate the in-hospital emergency team: causes and outcomes.
abstract: To determine the incidence of afferent limb failure of the in-hospital Medical Emergency Team, characterizing it and comparing the mortality between the population experiencing afferent limb failure and the population not experiencing afferent limb failure.
  A total of 478 activations of the Medical Emergency Team of Hospital Pedro Hispano occurred from January 2013 to July 2015. A sample of 285 activations was obtained after excluding incomplete records and activations for patients with less than 6 hours of hospitalization. The sample was divided into two groups: the group experiencing afferent limb failure and the group not experiencing afferent limb failure of the Medical Emergency Team. Both populations were characterized and compared. Statistical significance was set at p ≤ 0.05.
  Afferent limb failure was observed in 22.1% of activations. The causal analysis revealed significant differences in Medical Emergency Team activation criteria (p = 0.003) in the group experiencing afferent limb failure, with higher rates of Medical Emergency Team activation for cardiac arrest and cardiovascular dysfunction. Regarding patient outcomes, the group experiencing afferent limb failure had higher immediate mortality rates and higher mortality rates at hospital discharge, with no significant differences. No significant differences were found for the other parameters.
  The incidence of cardiac arrest and the mortality rate were higher in patients experiencing failure of the afferent limb of the Medical Emergency Team. This study highlights the need for health units to invest in the training of all healthcare professionals regarding the Medical Emergency Team activation criteria and emergency medical response system operations.
authors.affiliation: Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, EPE - Senhora da Hora, Portugal.
authors.forename: Vera
authors.initials: V
authors.lastname: Barbosa
authors.affiliation: Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, EPE - Senhora da Hora, Portugal.
authors.forename: Ernestina
authors.initials: E
authors.lastname: Gomes
authors.affiliation: Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, EPE - Senhora da Hora, Portugal.
authors.forename: Senio
authors.initials: S
authors.lastname: Vaz
authors.affiliation: Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, EPE - Senhora da Hora, Portugal.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Azevedo
authors.affiliation: Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, EPE - Senhora da Hora, Portugal.
authors.forename: Gonçalo
authors.initials: G
authors.lastname: Fernandes
authors.affiliation: Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, EPE - Senhora da Hora, Portugal.
authors.forename: Amélia
authors.initials: A
authors.lastname: Ferreira
authors.affiliation: Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, EPE - Senhora da Hora, Portugal.
authors.forename: Rui
authors.initials: R
authors.lastname: Araujo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006323:Heart Arrest / Q000453:epidemiology / Q000401:mortality / Q000628:therapy*; D017052:Hospital Mortality; D057209:Hospital Rapid Response Team / Q000592:standards / Q000706:statistics & numerical data*; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011174:Portugal; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult