No abstract

BACKGROUND: Cardiac arrests in hospital areas are common, and hospitals have rapid response teams or "blue code teams" to reduce preventable in-hospital deaths. Education about the rapid response team has been provided in all hospitals in Turkey, but true "blue code" activation is rare, and it is abused by medical personnel in practice. This study aimed to determine the cases of wrong blue codes and reasons of misuse. METHODS: This retrospective study analyzed the blue code reports issued by our hospital between January 1 and June 1 2012. A total of 89 "blue code" activations were recorded in 5 months. A "blue code" was defi ned as any patient with an unexpected cardiac or respiratory arrest requiring resuscitation and activation of a hospital alert. Adherence to this defi nition, each physician classifi ed their collected activation forms as either a true or a wrong code. Then, patient data entered a database (Microsoft Excel 2007 software) which was pooled for analysis. The data were analyzed by using frequencies and the Chi-square test on SPSSv16.0. RESULTS: The patients were diagnosed with cardiopulmonary arrest (8), change in mental status (18), presyncope (11), chest pain (12), conversive disorder (18), and worry of the staff for the patient (22). Code activation was done by physicians in 76% of the patients; the most common reason for blue code was concern of staff for the patient. CONCLUSION: The fi ndings of this study show that more research is needed to establish the overall effectiveness and optimal implementation of blue code teams.

No abstract

Background Determining the factors affecting the mortality and clinical conditions of the patients with Covid-19 are indispensable needs in developing patient treatment algorithms. We aimed to determine the parameters that can predict the mortality of moderate to severely ill patients with laboratory confirmed Covid-19. Methods Moderate to severely ill, Covid-19 patients older than 18 years were included. Mild Covid-19 patients and the ones with negative polymerase chain reaction test results were excluded from the study. The primary outcome of the study was 30-day mortality rate and we aimed to determine the factors affecting mortality in moderate to severely ill Covid-19 patients. Results 168 patient results were analyzed. Median age of the patients was 59.5 (48.3 to 76) and 90 (53.6%) were male. According to multivariate regression analysis results, the presence of any comorbid disease ( p = 0.027, HR = 26.11 (95%CI: 1.45 to 471.31)), elevated C-reactive protein levels (CRP) ( p < 0.001, HR = 1.24 (95%CI: 1.11 to 1.38)) and presence of dyspnea ( p = 0.026, HR = 4.26 ((95%CI: 1.19 to 15.28)) were found to significantly increase the mortality, while high pulse O 2 saturation level (p < 0.001, HR = 0.90 (95%CI: 0.82 to 0.99) was found to decrease. When receiver operating characteristic curve was created for laboratory tests, it was determined that white blood cell counts, neutrophil counts, CRP levels and neutrophil/lymphocyte ratio predicted mortality while Lymphocyte levels did not. Conclusion Dyspnea, the presence of any comorbid disease, elevated CRP levels, and low pulse O 2 saturation levels predict mortality in moderate to severely ill Covid-19 patients.