Outcome of adult patients attended by rapid response teams: A systematic review of the literature

Background An abundance of studies have investigated the impact of rapid response teams (RRTs) on in-hospital cardiac arrest rates. However, existing RRT data appear highly variable in terms of both study quality and reported uses of limitations of care, patient survival and patient long-term outcome. Methods A systematic electronic literature search (January, 1990–March, 2016) of the PubMed and Cochrane databases was performed. Bibliographies of articles included in the full-text review were searched for additional studies. A predefined RRT cohort quality score (range 0–17) was used to evaluate studies independently by two reviewers. Results Twenty-nine studies with a total of 157,383 RRT activations were included in this review. The quality of data reporting related to RRT patients was assessed as modest, with a median quality score of 8 (range 2–11). Data from the included studies indicate that a median 8.1% of RRT reviews result in limitations of medical treatment (range 2.1–25%) and 23% (8.2–56%) result in a transfer to intensive care. A median of 29% (6.9–35%) of patients transferred to intensive care died during that admission. The median hospital mortality of patients reviewed by RRT is 26% (12–60%), and the median 30-day mortality rate is 29% (8–39%). Data on long-term survival is minimal. No data on functional outcomes was identified. Conclusions Patients reviewed by rapid response teams have a high and variable mortality rate, and limitations of care are commonly used. Data on the long-term outcomes of RRT are lacking and needed.