considine-characteristics-2014.pdf (374.45 kB)
Characteristics and outcomes of patients requiring rapid response system activation within 24 hours of emergency admission
journal contribution
posted on 2014-09-01, 00:00 authored by Julie ConsidineJulie Considine, D Charlesworth, Judy CurreyJudy CurreyObjectives:
To establish the prevalence of emergency responses for clinical deterioration (cardiac arrest team or medical emergency team [MET] activation) within 24 hours of emergency admission, and determine if there were differences in characteristics and outcomes of ward patients whose emergency response was within, or beyond, 24 hours of emergency admission.
Design, setting and participants:
A retrospective, descriptive, exploratory study using MET, cardiac arrest, emergency department and inpatient databases, set in a 365-bed urban district hospital in Melbourne, Australia. Participants were adult hospital inpatients admitted to a medical or surgical ward via the emergency department (ED) who needed an emergency response for clinical deterioration during 2012.
Main outcome measures:
Inhospital mortality, unplanned intensive care unit admission and hospital length of stay (LOS).
Results:
A total of 819 patients needed an emergency response for clinical deterioration: 587 patients were admitted via the ED and 28.4% of emergency responses occurred within 24 hours of emergency admission. Patients whose first emergency response was within 24 hours of emergency admission (compared with beyond 24 hours) were more likely to be triaged to Australasian triage scale category 1 (5.4% v 1.2%, P=0.005), less likely to require ICU admission after the emergency response (7.6% v 13.9%, P=0.039), less likely to have recurrent emergency responses during their hospital stay (9.7% v 34%, P < 0.001) and had a shorter median hospital LOS (7 days v 11 days, P < 0.001).
Conclusions:
One-quarter of emergency responses after admission via the ED occurred within 24 hours. Further research is needed to understand the predictors of deterioration in patients needing emergency admission.
Design, setting and participants:
A retrospective, descriptive, exploratory study using MET, cardiac arrest, emergency department and inpatient databases, set in a 365-bed urban district hospital in Melbourne, Australia. Participants were adult hospital inpatients admitted to a medical or surgical ward via the emergency department (ED) who needed an emergency response for clinical deterioration during 2012.
Main outcome measures:
Inhospital mortality, unplanned intensive care unit admission and hospital length of stay (LOS).
Results:
A total of 819 patients needed an emergency response for clinical deterioration: 587 patients were admitted via the ED and 28.4% of emergency responses occurred within 24 hours of emergency admission. Patients whose first emergency response was within 24 hours of emergency admission (compared with beyond 24 hours) were more likely to be triaged to Australasian triage scale category 1 (5.4% v 1.2%, P=0.005), less likely to require ICU admission after the emergency response (7.6% v 13.9%, P=0.039), less likely to have recurrent emergency responses during their hospital stay (9.7% v 34%, P < 0.001) and had a shorter median hospital LOS (7 days v 11 days, P < 0.001).
Conclusions:
One-quarter of emergency responses after admission via the ED occurred within 24 hours. Further research is needed to understand the predictors of deterioration in patients needing emergency admission.
History
Journal
Critical care and resuscitationVolume
16Issue
3Pagination
184 - 189Publisher
College of Intensive Care Medicine of Australia and New ZealandLocation
Melbourne, Vic.ISSN
1441-2772Language
engPublication classification
C1 Refereed article in a scholarly journal; C Journal articleCopyright notice
2014, College of Intensive Care Medicine of Australia and New ZealandUsage metrics
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