Epidemiology of early Rapid Response Team activation after Emergency Department admission
| Autor: | Daryl A Jones, Yu-Feng Frank Hsiao, Raymond J Robbins, Antoine G. Schneider, Juan Carlos Mora, Julie Considine, Bronwyn Bebee, Rinaldo Bellomo, Michael Bailey |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Victoria Respiratory rate Vital signs Emergency Nursing 03 medical and health sciences 0302 clinical medicine Risk Factors Intensive care Heart rate medicine Humans 030212 general & internal medicine Rapid response team Aged Retrospective Studies Aged 80 and over business.industry 030208 emergency & critical care medicine Retrospective cohort study General Medicine Emergency department Middle Aged Triage Hospitalization Case-Control Studies Emergency medicine Female Emergency Service Hospital business Hospital Rapid Response Team |
| Zdroj: | Australasian Emergency Nursing Journal. 19:54-61 |
| ISSN: | 1574-6267 |
| DOI: | 10.1016/j.aenj.2015.05.001 |
| Popis: | Summary Background Rapid Response Team (RRT) calls can often occur within 24h of hospital admission to a general ward. We seek to determine whether it is possible to identify these patients before there is a significant clinical deterioration. Methods Retrospective case–controlled study comparing patient characteristics, vital signs, and hospital outcomes in patients triggering RRT activation within 24h of ED admission (cases) with matched ED admissions not receiving a RRT call (controls). Results Over 12 months, there were 154 early RRT calls. Compared with controls, cases had a higher heart rate (HR) at triage (92 vs. 84beats/min; p =0.008); after 3h in the ED (91 vs. 80beats/min; p =0.0007); and at ED discharge (91 vs. 81beats/min; p =0.0005). Respiratory rate (RR) was also higher at triage (21.2 vs. 19.2breaths/min; p =0.001). On multiple variable analysis, RR at triage and HR before ward transfer predicted early RRT activation: OR 1.07 [95% CI 1.02–1.12] for each 1breath/min increase in RR; and 1.02 [95% CI 1.002–1.030] for each beat/minute increase in HR, respectively. Study patients required transfer to the intensive care in approximately 20% of cases and also had a greater mortality: (21% vs. 6%; OR 4.65 [95% CI 1.86–11.65]; p =0.0003) compared with controls. Conclusions Patients that trigger RRT calls within 24h of admission have a fourfold increase in risk of in-hospital mortality. Such patients may be identified by greater tachycardia and tachypnoea in the ED. |
| Databáze: | OpenAIRE |
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