title: Outcome of adult patients attended by rapid response teams: A systematic review of the literature.
abstract: An abundance of studies have investigated the impact of rapid response teams (RRTs) on in-hospital cardiac arrest rates. However, existing RRT data appear highly variable in terms of both study quality and reported uses of limitations of care, patient survival and patient long-term outcome.
  
  
  
  A systematic electronic literature search (January, 1990-March, 2016) of the PubMed and Cochrane databases was performed. Bibliographies of articles included in the full-text review were searched for additional studies. A predefined RRT cohort quality score (range 0-17) was used to evaluate studies independently by two reviewers.
  
  
  
  Twenty-nine studies with a total of 157,383 RRT activations were included in this review. The quality of data reporting related to RRT patients was assessed as modest, with a median quality score of 8 (range 2-11). Data from the included studies indicate that a median 8.1% of RRT reviews result in limitations of medical treatment (range 2.1-25%) and 23% (8.2-56%) result in a transfer to intensive care. A median of 29% (6.9-35%) of patients transferred to intensive care died during that admission. The median hospital mortality of patients reviewed by RRT is 26% (12-60%), and the median 30-day mortality rate is 29% (8-39%). Data on long-term survival is minimal. No data on functional outcomes was identified.
  
  
  
  Patients reviewed by rapid response teams have a high and variable mortality rate, and limitations of care are commonly used. Data on the long-term outcomes of RRT are lacking and needed.
authors.affiliation: Department of Intensive Care Medicine, Tampere University Hospital and Department of Anaesthesiology and Intensive Care Medicine, Seinäjoki Central Hospital, P.O. Box 2000, FI-33521 Tampere, Finland. Electronic address: tirkkonen.joonas.o@student.uta.fi.
authors.forename: Joonas
authors.initials: J
authors.lastname: Tirkkonen
authors.affiliation: Division of Intensive Care, Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University and Helsinki University Hospital, Finland.
authors.forename: Tero
authors.initials: T
authors.lastname: Tamminen
authors.affiliation: Division of Intensive Care, Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University and Helsinki University Hospital, Finland; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Australia.
authors.forename: Markus B
authors.initials: MB
authors.lastname: Skrifvars
mesh_terms: D000328:Adult; D006323:Heart Arrest / Q000401:mortality* / Q000628:therapy*; D017052:Hospital Mortality; D057209:Hospital Rapid Response Team; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D064887:Observational Studies as Topic; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Medical emergency team; Outcome; Rapid response team