title: Differences in the Clinical Characteristics of Rapid Response System Activation in Patients Admitted to Medical or Surgical Services.
abstract: Variability in rapid response system (RRS) characteristics based on the admitted wards is unknown. We aimed to compare differences in the clinical characteristics of RRS activation between patients admitted to medical versus surgical services. We reviewed patients admitted to the hospital who were detected by the RRS from October 2012 to February 2014 at a tertiary care academic hospital. We compared the triggers for RRS activation, interventions performed, and outcomes of the 2 patient groups. The RRS was activated for 460 patients, and the activation rate was almost 2.3 times higher for surgical services than that for medical services (70% vs. 30%). The triggers for RRS activation significantly differed between patient groups (P = 0.001). They included abnormal values for the respiratory rate (23.2%) and blood gas analysis (20.3%), and low blood pressure (18.8%) in the medical group; and low blood pressure (32.0%), low oxygen saturation (20.8%), and an abnormal heart rate (17.7%) in the surgical group. Patients were more likely classified as do not resuscitate or required intensive care unit admission in the medical group compared to those in the surgical group (65.3% vs. 54.7%, P = 0.045). In multivariate analysis, whether the patient belongs to medical services was found to be an independent predictor of mortality after adjusting for the modified early warning score, Charlson comorbidity index, and intervention performed by the RRS team. Our data suggest that RRS triggers, interventions, and outcomes greatly differ between patient groups. Further research is needed to evaluate the efficacy of an RRS approach tailored to specific patient groups.
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.|Interdepartment of Critical Care Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Yeon Joo
authors.identifier: http://orcid.org/0000-0001-7697-4272
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Interdepartment of Critical Care Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Dong Seon
authors.identifier: http://orcid.org/0000-0002-4917-5990
authors.initials: DS
authors.lastname: Lee
authors.affiliation: Interdepartment of Critical Care Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Hyunju
authors.identifier: http://orcid.org/0000-0002-5974-3779
authors.initials: H
authors.lastname: Min
authors.affiliation: Interdepartment of Critical Care Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Yun Young
authors.identifier: http://orcid.org/0000-0002-2813-4479
authors.initials: YY
authors.lastname: Choi
authors.affiliation: Interdepartment of Critical Care Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Eun Young
authors.identifier: http://orcid.org/0000-0001-6718-6952
authors.initials: EY
authors.lastname: Lee
authors.affiliation: Interdepartment of Critical Care Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.|Department of Anesthesiology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Inae
authors.identifier: http://orcid.org/0000-0001-9961-7593
authors.initials: I
authors.lastname: Song
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Yeonyee E
authors.identifier: http://orcid.org/0000-0002-8479-9889
authors.initials: YE
authors.lastname: Yoon
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Jin Won
authors.identifier: http://orcid.org/0000-0002-1357-7015
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Jong Sun
authors.identifier: http://orcid.org/0000-0003-3707-3636
authors.initials: JS
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.|Interdepartment of Critical Care Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Young Jae
authors.identifier: http://orcid.org/0000-0001-6943-4462
authors.initials: YJ
authors.lastname: Cho
authors.affiliation: Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Jae Hyuk
authors.identifier: http://orcid.org/0000-0003-2429-4085
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Jung Won
authors.identifier: http://orcid.org/0000-0002-0397-6071
authors.initials: JW
authors.lastname: Suh
authors.affiliation: Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: You Hwan
authors.identifier: http://orcid.org/0000-0002-9507-7603
authors.initials: YH
authors.lastname: Jo
authors.affiliation: Interdepartment of Critical Care Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.|Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Kyuseok
authors.identifier: http://orcid.org/0000-0002-7991-9428
authors.initials: K
authors.lastname: Kim
authors.affiliation: Interdepartment of Critical Care Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.|Department of Anesthesiology, Seoul National University Bundang Hospital, Seongnam, Korea.|Department of Anesthesiology, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, United Arab Emirates. psh1399@gmail.com.
authors.forename: Sangheon
authors.identifier: http://orcid.org/0000-0001-8563-7681
authors.initials: S
authors.lastname: Park
mesh_terms: D000368:Aged; D001784:Blood Gas Analysis; D001794:Blood Pressure; D005260:Female; D006339:Heart Rate; D017052:Hospital Mortality; D057209:Hospital Rapid Response Team; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010101:Oxygen Consumption; D010343:Patient Admission / Q000706:statistics & numerical data*; D056152:Respiratory Rate; D012189:Retrospective Studies; D062606:Tertiary Care Centers
keywords: Hospital Mortality; Hospital Rapid Response Team; Intensive Care Unit; Patient Admission; Tertiary Care Centers