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Physiological status during emergency department care : relationship with inhospital death after clinical deterioration

Considine, Julie, Jones, Daryl, Pilcher, David and Currey, Judy 2015, Physiological status during emergency department care : relationship with inhospital death after clinical deterioration, Critical care and resuscitation, vol. 17, no. 4, pp. 257-262.

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Title Physiological status during emergency department care : relationship with inhospital death after clinical deterioration
Author(s) Considine, JulieORCID iD for Considine, Julie orcid.org/0000-0003-3801-2456
Jones, Daryl
Pilcher, David
Currey, JudyORCID iD for Currey, Judy orcid.org/0000-0002-0574-0054
Journal name Critical care and resuscitation
Volume number 17
Issue number 4
Start page 257
End page 262
Total pages 6
Publisher College of Intensive Care Medicine of Australia and New Zealand
Place of publication Prahran, Vic.
Publication date 2015-12
ISSN 1441-2772
Summary OBJECTIVE: To examine the relationship between patient physiological status in the emergency department (ED) and inhospital mortality after rapid response team (RRT) or cardiac arrest team (CAT) activations within 72 hours of emergency admission to medical or surgical wards. DESIGN, SETTING AND PARTICIPANTS: A multisite, retrospective, cohort study of 660 randomly selected (220 patients per site) adult medical or surgical patients who were admitted from the ED during 2012 and who had had an RRT or CAT activation within 72 hours of admission, at three hospitals in Melbourne, Australia. MAIN OUTCOME MEASURE: Inhospital mortality. RESULTS: There were 825 RRT activations (for 634 patients) and 42 CAT activations (for 35 patients). The median time to the first RRT or CAT activation was 18.8 hours and was significantly shorter in patients who died in hospital (14.6 v 20.6 hours, P=0.036). Compared with survivors, patients who died were more likely to have at least one observation meeting RRT criteria during their ED stay (45.9% v 34.8%; P=0.029): tachypnoea (21.1% v 13.4%, P=0.039), hypotension (20.2% v 11.8%, P=0.018), hypoxaemia (8.3% v 3.1%, P=0.001) and altered conscious state (6.2% v 1.3%, P=0.001) were more common in patients who died. The risk-adjusted odds ratio (OR) for inhospital death was highest for patients with an altered conscious state during their ED stay (OR, 4.633; 95% CI, 1.365-15.728; P=0.014). CONCLUSIONS: In patients who needed an RRT or CAT activation within the first 72 hours of emergency admission to medical or surgical wards, there was a strong association between physiological derangement during ED care and inhospital death.
Language eng
Field of Research 111003 Clinical Nursing: Secondary (Acute Care)
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, College of Intensive Care Medicine of Australia and New Zealand
Free to Read? Yes
Persistent URL http://hdl.handle.net/10536/DRO/DU:30080525

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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.