The impact of delayed rapid response call activation on patient outcomes

Sachin Gupta, Cameron Green, Ashwin Subramaniam, Lim Dee Zhen, Elizabeth Low, Ravindranath Tiruvoipati

Research output: Contribution to journalArticleResearchpeer-review

2 Citations (Scopus)

Abstract

Purpose To investigate the impact of delay in rapid response call (RRC) activation on Hospital mortality. Materials and methods This study was conducted in a university affiliated hospital providing medical, surgical, mental health, maternity, and pediatric services. RRCs were considered delayed if RRC activation was delayed by ≥ 15 min. The primary outcome measure was in-hospital mortality. Secondary outcomes included hospital length of stay (LOS), requirement of ICU admission, as well as requirement of mechanical ventilation and ICU LOS for patients requiring ICU admission. Results A total of 826 RRCs occurred in 629 patient admissions. A quarter of all RRCs were delayed by ≥ 15 min, with a median delay of 1 h and 20 min. Patients with a delayed RRC had significantly higher in-hospital mortality (34.7% vs. 21.2%; p = 0.001,) and significantly longer hospitalizations (11.6 vs. 8.4 days; p = 0.036). After adjusting for confounders, RRC activation was independently associated with increased in-hospital mortality (OR = 1.79; 95% CI = 1.17–2.72: p = 0.007). Conclusions A delay of ≥ 15 min was associated with significantly increased in-hospital mortality and longer hospitalization. The factors contributing to the observed increase in mortality with delayed RRCs require further exploration.

Original languageEnglish
Pages (from-to)86-90
Number of pages5
JournalJournal of Critical Care
Volume41
DOIs
Publication statusPublished - 1 Oct 2017

Keywords

  • Delay
  • Hospitalization
  • Intensive care
  • Mortality
  • Rapid response

Cite this

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title = "The impact of delayed rapid response call activation on patient outcomes",
abstract = "Purpose To investigate the impact of delay in rapid response call (RRC) activation on Hospital mortality. Materials and methods This study was conducted in a university affiliated hospital providing medical, surgical, mental health, maternity, and pediatric services. RRCs were considered delayed if RRC activation was delayed by ≥ 15 min. The primary outcome measure was in-hospital mortality. Secondary outcomes included hospital length of stay (LOS), requirement of ICU admission, as well as requirement of mechanical ventilation and ICU LOS for patients requiring ICU admission. Results A total of 826 RRCs occurred in 629 patient admissions. A quarter of all RRCs were delayed by ≥ 15 min, with a median delay of 1 h and 20 min. Patients with a delayed RRC had significantly higher in-hospital mortality (34.7{\%} vs. 21.2{\%}; p = 0.001,) and significantly longer hospitalizations (11.6 vs. 8.4 days; p = 0.036). After adjusting for confounders, RRC activation was independently associated with increased in-hospital mortality (OR = 1.79; 95{\%} CI = 1.17–2.72: p = 0.007). Conclusions A delay of ≥ 15 min was associated with significantly increased in-hospital mortality and longer hospitalization. The factors contributing to the observed increase in mortality with delayed RRCs require further exploration.",
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The impact of delayed rapid response call activation on patient outcomes. / Gupta, Sachin; Green, Cameron; Subramaniam, Ashwin; Zhen, Lim Dee; Low, Elizabeth; Tiruvoipati, Ravindranath.

In: Journal of Critical Care, Vol. 41, 01.10.2017, p. 86-90.

Research output: Contribution to journalArticleResearchpeer-review

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N2 - Purpose To investigate the impact of delay in rapid response call (RRC) activation on Hospital mortality. Materials and methods This study was conducted in a university affiliated hospital providing medical, surgical, mental health, maternity, and pediatric services. RRCs were considered delayed if RRC activation was delayed by ≥ 15 min. The primary outcome measure was in-hospital mortality. Secondary outcomes included hospital length of stay (LOS), requirement of ICU admission, as well as requirement of mechanical ventilation and ICU LOS for patients requiring ICU admission. Results A total of 826 RRCs occurred in 629 patient admissions. A quarter of all RRCs were delayed by ≥ 15 min, with a median delay of 1 h and 20 min. Patients with a delayed RRC had significantly higher in-hospital mortality (34.7% vs. 21.2%; p = 0.001,) and significantly longer hospitalizations (11.6 vs. 8.4 days; p = 0.036). After adjusting for confounders, RRC activation was independently associated with increased in-hospital mortality (OR = 1.79; 95% CI = 1.17–2.72: p = 0.007). Conclusions A delay of ≥ 15 min was associated with significantly increased in-hospital mortality and longer hospitalization. The factors contributing to the observed increase in mortality with delayed RRCs require further exploration.

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