1. Risk Factors for Early Medical Emergency Team Reactivation in Hospitalized Patients
- Author
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Chi Ryang Chung, Soo Jin Na, Ryoung-Eun Ko, Kyeongman Jeon, Myeong Gyun Ko, Gee Young Suh, and Ahra Koh
- Subjects
Male ,Multivariate analysis ,education ,Psychological intervention ,MEDLINE ,Critical Care and Intensive Care Medicine ,Tertiary referral hospital ,Chronic liver disease ,Tachypnea ,03 medical and health sciences ,Liver disease ,0302 clinical medicine ,Risk Factors ,Early Medical Intervention ,medicine ,Humans ,Aged ,Retrospective Studies ,business.industry ,030208 emergency & critical care medicine ,Odds ratio ,Middle Aged ,medicine.disease ,Hospitalization ,Intensive Care Units ,030228 respiratory system ,Female ,Medical emergency ,medicine.symptom ,business ,Hospital Rapid Response Team - Abstract
OBJECTIVES The objective of this study was to investigate the risk factors for early medical emergency team reactivation (which is defined as repeated medical emergency team calls within 72 hr after the index medical emergency team call) in the patients remaining on the ward after index medical emergency team activation. DESIGN Retrospective analysis with prospectively collected data. SETTING A university-affiliated, tertiary referral hospital. PATIENTS All consecutive patients over 18 years old who received medical emergency team intervention. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Of the 3,989 cases eligible for analysis, 514 cases (12.9%) were classified into the reactivation group, with the remainder assigned to the nonreactivation group. In a multivariate analysis, chronic lung disease (odds ratio, 1.38; 95% CI, 1.03-1.86; p = 0.032), chronic liver disease (odds ratio, 1.44; 95% CI, 1.04-1.99; p = 0.028), activation due to bedside concern about overall deterioration without abnormal physiological variables (odds ratio, 1.30; 95% CI, 1.00-1.68; p = 0.049), advice or consultation only for medical emergency team intervention (odds ratio, 0.78; 95% CI, 0.63-0.97; p = 0.027), and discussion about treatment limitation (odds ratio, 0.39; 95% CI, 0.25-0.60; p < 0.001) were independently associated with medical emergency team reactivation. In the reactivation group, 249 patients (48.5%) were transferred to the ICU after repeated calls. Medical department admission (odds ratio, 1.68; 95% CI, 1.12-2.52; p = 0.012), chronic liver disease (odds ratio, 1.73; 95% CI, 1.07-2.79; p = 0.025), hematological malignancies (odds ratio, 1.63; 95% CI, 1.10-2.41; p = 0.015), and tachypnea at the end of medical emergency team were risk factors for medical emergency team reactivation requiring ICU admission. Discussion about treatment limitation (odds ratio, 0.14; 95% CI, 0.05-0.40; p < 0.001) was also associated with decreased risk of medical emergency team reactivation requiring ICU admission. CONCLUSIONS An increased risk of early medical emergency team reactivation was associated with medical emergency team activation by bedside concern about overall deterioration and patients with chronic lung or liver disease.
- Published
- 2020