A prospective study of factors influencing the outcome of patients after a Medical Emergency Team review

Paolo Calzavacca, Elisa Licari, Augustine Tee, Moritoki Egi, Michael Haase, Anja Haase-Fielitz, Rinaldo Bellomo

Research output: Contribution to journalArticleResearchpeer-review

55 Citations (Scopus)

Abstract

Objective: To identify factors that predict outcome in patients receiving a Medical Emergency Team review. Design: Prospective observational study. Setting: Tertiary hospital. Patients: Cohort of 228 patients receiving one or more Medical Emergency Team reviews during daytime hours over a 1-year-period. Control cohort of all patients (n = 900) receiving a Medical Emergency Team review in the same period. Measurements and results: We prospectively collected information from patients receiving a Medical Emergency Team review during daytime hours from Monday to Friday (audit group) including the clinical cause of deterioration and timing of call in relation to the first documented Medical Emergency Team call criterion (activation delay). We also collected information from the hospital Medical Emergency Team database regarding all patients visited by the Medical Emergency Team during the same period (complete cohort). Audit group patients had several similar characteristics to complete cohort patients but were less likely to be not-for-resuscitation before Medical Emergency Team review and more likely to receive a Medical Emergency Team review because of hypotension, change in neurological status and oliguria. Conclusion: Delayed Medical Emergency Team activation and not-for resuscitation orders were the only factors to show an independent statistical association with mortality (OR 2.53, 95% CI: 1.2-5.31, P = 0.01 and OR 5.63, 95% CI: 2.81-11.28, P < 0.01, respectively). Delayed Medical Emergency Team activation and NFR orders are the strongest independent predictors of mortality in patients receiving a Medical Emergency Team review. Avoidance of delayed Medical Emergency Team activation should be a priority for hospitals operating rapid response systems.

Original languageEnglish
Pages (from-to)2112-2116
Number of pages5
JournalIntensive Care Medicine
Volume34
Issue number11
DOIs
Publication statusPublished - 1 Nov 2008
Externally publishedYes

Keywords

  • Critical illness
  • Medical Emergency Team
  • Mortality
  • Rapid response system
  • Vital signs

Cite this

Calzavacca, Paolo ; Licari, Elisa ; Tee, Augustine ; Egi, Moritoki ; Haase, Michael ; Haase-Fielitz, Anja ; Bellomo, Rinaldo. / A prospective study of factors influencing the outcome of patients after a Medical Emergency Team review. In: Intensive Care Medicine. 2008 ; Vol. 34, No. 11. pp. 2112-2116.
@article{cb121a6b0f7042039a2a2b6ea73440c6,
title = "A prospective study of factors influencing the outcome of patients after a Medical Emergency Team review",
abstract = "Objective: To identify factors that predict outcome in patients receiving a Medical Emergency Team review. Design: Prospective observational study. Setting: Tertiary hospital. Patients: Cohort of 228 patients receiving one or more Medical Emergency Team reviews during daytime hours over a 1-year-period. Control cohort of all patients (n = 900) receiving a Medical Emergency Team review in the same period. Measurements and results: We prospectively collected information from patients receiving a Medical Emergency Team review during daytime hours from Monday to Friday (audit group) including the clinical cause of deterioration and timing of call in relation to the first documented Medical Emergency Team call criterion (activation delay). We also collected information from the hospital Medical Emergency Team database regarding all patients visited by the Medical Emergency Team during the same period (complete cohort). Audit group patients had several similar characteristics to complete cohort patients but were less likely to be not-for-resuscitation before Medical Emergency Team review and more likely to receive a Medical Emergency Team review because of hypotension, change in neurological status and oliguria. Conclusion: Delayed Medical Emergency Team activation and not-for resuscitation orders were the only factors to show an independent statistical association with mortality (OR 2.53, 95{\%} CI: 1.2-5.31, P = 0.01 and OR 5.63, 95{\%} CI: 2.81-11.28, P < 0.01, respectively). Delayed Medical Emergency Team activation and NFR orders are the strongest independent predictors of mortality in patients receiving a Medical Emergency Team review. Avoidance of delayed Medical Emergency Team activation should be a priority for hospitals operating rapid response systems.",
keywords = "Critical illness, Medical Emergency Team, Mortality, Rapid response system, Vital signs",
author = "Paolo Calzavacca and Elisa Licari and Augustine Tee and Moritoki Egi and Michael Haase and Anja Haase-Fielitz and Rinaldo Bellomo",
year = "2008",
month = "11",
day = "1",
doi = "10.1007/s00134-008-1229-y",
language = "English",
volume = "34",
pages = "2112--2116",
journal = "Intensive Care Medicine",
issn = "0342-4642",
publisher = "Springer-Verlag London Ltd.",
number = "11",

}

A prospective study of factors influencing the outcome of patients after a Medical Emergency Team review. / Calzavacca, Paolo; Licari, Elisa; Tee, Augustine; Egi, Moritoki; Haase, Michael; Haase-Fielitz, Anja; Bellomo, Rinaldo.

In: Intensive Care Medicine, Vol. 34, No. 11, 01.11.2008, p. 2112-2116.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - A prospective study of factors influencing the outcome of patients after a Medical Emergency Team review

AU - Calzavacca, Paolo

AU - Licari, Elisa

AU - Tee, Augustine

AU - Egi, Moritoki

AU - Haase, Michael

AU - Haase-Fielitz, Anja

AU - Bellomo, Rinaldo

PY - 2008/11/1

Y1 - 2008/11/1

N2 - Objective: To identify factors that predict outcome in patients receiving a Medical Emergency Team review. Design: Prospective observational study. Setting: Tertiary hospital. Patients: Cohort of 228 patients receiving one or more Medical Emergency Team reviews during daytime hours over a 1-year-period. Control cohort of all patients (n = 900) receiving a Medical Emergency Team review in the same period. Measurements and results: We prospectively collected information from patients receiving a Medical Emergency Team review during daytime hours from Monday to Friday (audit group) including the clinical cause of deterioration and timing of call in relation to the first documented Medical Emergency Team call criterion (activation delay). We also collected information from the hospital Medical Emergency Team database regarding all patients visited by the Medical Emergency Team during the same period (complete cohort). Audit group patients had several similar characteristics to complete cohort patients but were less likely to be not-for-resuscitation before Medical Emergency Team review and more likely to receive a Medical Emergency Team review because of hypotension, change in neurological status and oliguria. Conclusion: Delayed Medical Emergency Team activation and not-for resuscitation orders were the only factors to show an independent statistical association with mortality (OR 2.53, 95% CI: 1.2-5.31, P = 0.01 and OR 5.63, 95% CI: 2.81-11.28, P < 0.01, respectively). Delayed Medical Emergency Team activation and NFR orders are the strongest independent predictors of mortality in patients receiving a Medical Emergency Team review. Avoidance of delayed Medical Emergency Team activation should be a priority for hospitals operating rapid response systems.

AB - Objective: To identify factors that predict outcome in patients receiving a Medical Emergency Team review. Design: Prospective observational study. Setting: Tertiary hospital. Patients: Cohort of 228 patients receiving one or more Medical Emergency Team reviews during daytime hours over a 1-year-period. Control cohort of all patients (n = 900) receiving a Medical Emergency Team review in the same period. Measurements and results: We prospectively collected information from patients receiving a Medical Emergency Team review during daytime hours from Monday to Friday (audit group) including the clinical cause of deterioration and timing of call in relation to the first documented Medical Emergency Team call criterion (activation delay). We also collected information from the hospital Medical Emergency Team database regarding all patients visited by the Medical Emergency Team during the same period (complete cohort). Audit group patients had several similar characteristics to complete cohort patients but were less likely to be not-for-resuscitation before Medical Emergency Team review and more likely to receive a Medical Emergency Team review because of hypotension, change in neurological status and oliguria. Conclusion: Delayed Medical Emergency Team activation and not-for resuscitation orders were the only factors to show an independent statistical association with mortality (OR 2.53, 95% CI: 1.2-5.31, P = 0.01 and OR 5.63, 95% CI: 2.81-11.28, P < 0.01, respectively). Delayed Medical Emergency Team activation and NFR orders are the strongest independent predictors of mortality in patients receiving a Medical Emergency Team review. Avoidance of delayed Medical Emergency Team activation should be a priority for hospitals operating rapid response systems.

KW - Critical illness

KW - Medical Emergency Team

KW - Mortality

KW - Rapid response system

KW - Vital signs

UR - http://www.scopus.com/inward/record.url?scp=54449090872&partnerID=8YFLogxK

U2 - 10.1007/s00134-008-1229-y

DO - 10.1007/s00134-008-1229-y

M3 - Article

C2 - 18651130

AN - SCOPUS:54449090872

VL - 34

SP - 2112

EP - 2116

JO - Intensive Care Medicine

JF - Intensive Care Medicine

SN - 0342-4642

IS - 11

ER -