Elderly patients are at high risk of night‐time admission to the intensive care unit following a rapid response team call

Sundararajan, K.; Flabouris, Arthas; Thompson, C.; Seppelt, Ian

doi:10.1111/imj.13281

Cited by 4 publications

(5 citation statements)

References 12 publications

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“…Of the 28 included studies, 25 were quantitative, 4,13–36 two were qualitative, 37,38 and one was a mixed‐methods study 39 . Studies with a quantitative design included nine cohort, six case–control, four secondary analyses, three descriptive, two feasibility, and one cross‐sectional study.…”

Section: Results/findingsmentioning

confidence: 99%

“…Studies relevant to the night‐time MET/RRT response showed that this category was either referred to as a MET or an RRT 13–26 . All these studies had been designed using quantitative methodologies that only included observational studies.…”

Section: Results/findingsmentioning

confidence: 99%

“…Studies relevant to the night-time MET/RRT response showed that this category was either referred to as a MET or an RRT. [13][14][15][16][17][18][19][20][21][22][23][24][25][26] All these studies had been designed using quantitative methodologies that only included observational studies. In these studies, most reports were related to variations in MET/RRT activations throughout the day, with some studies reporting on the relationships with patient outcomes.…”

Section: Night-time Met/rrt Responsementioning

confidence: 99%

“…Many findings on interventional measures in usual care settings have demonstrated that the performance of MET/RRT activations [13][14][15][16][17][18][19][20][21][22][23][24][25][26] and use of the EWS are less effective at night. 4,[27][28][29] We found that MET/RRT and the EWS were applied to usual care settings as the main night-time interventional measures, which could be related to the widespread use of RRS.…”

Section: Interventional Measures and Findings In Usual Care Settingsmentioning

confidence: 99%

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Night‐time detection and response in relation to deteriorating inpatients: A scoping review

Hotta

Ashida

Tanaka

2023

Nursing in Critical Care

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BackgroundAlthough detection and response to clinical deterioration have been studied, the range and nature of studies focused on night‐time clinical setting remain unclear.AimThis study aimed to identify and map existing research and findings concerning night‐time detection and response to deteriorating inpatients in usual care or research settings.Study Design and MethodsA scoping review method was used. PubMed, CINAHL, Web of Science, and Ichushi‐Web databases were systematically searched. We included studies focusing on night‐time detection and response to clinical deterioration.ResultsTwenty‐eight studies were included. These studies were organized into five categories: night‐time medical emergency team or rapid response team (MET/RRT) response, night‐time observation using the early warning score (EWS), available resources for physicians' practice, continuous monitoring of specific parameters, and screening for night‐time clinical deterioration. The first three categories were related to interventional measures in usual care settings, and relevant findings mainly demonstrated the actual situation and challenges of night‐time practice. The final two categories were related to the interventions in the research settings and included innovative interventions to identify at‐risk or deteriorating patients.ConclusionsSystematic interventional measures, such as MET/RRT and EWS, could have been sub‐optimally performed at night. Innovations in monitoring technologies or implementation of predictive models could be helpful in improving the detection of night‐time deterioration.Relevance to Clinical PracticeThis review provides a compilation of current evidence regarding night‐time practice concerning patient deterioration. However, a lack of understanding exists on specific and effective practices regarding timely action for deteriorating patients at night.

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Section: Results/findingsmentioning

confidence: 99%

Section: Results/findingsmentioning

confidence: 99%

Section: Night-time Met/rrt Responsementioning

confidence: 99%

Section: Interventional Measures and Findings In Usual Care Settingsmentioning

confidence: 99%

See 2 more Smart Citations

Night‐time detection and response in relation to deteriorating inpatients: A scoping review

Hotta

Ashida

Tanaka

2023

Nursing in Critical Care

View full text Add to dashboard Cite

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“…We found that children under 1 year of age were more likely to have SCD than older children. Older age has been associated with risk for deterioration in adults, emphasising that patients at extremes of age are vulnerable. Despite this increased risk, age is excluded from most early warning score systems .…”

Section: Discussionmentioning

confidence: 99%

Emergency department risk factors for serious clinical deterioration in a paediatric hospital in Peru

Nielsen

Rojas

Fieno

et al. 2018

J Paediatrics Child Health

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Unplanned ICU Admission From Hospital Wards After Rapid Response Team Review in Australia and New Zealand

Orosz

Bailey

Udy

et al. 2020

Critical Care Medicine

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Objectives: To evaluate what proportion of unplanned ICU admissions from hospital wards occurred after rapid response team review and compare baseline characteristics and outcomes of patients admitted after rapid response team review with non-rapid response team-related admissions. Design: Multicenter binational retrospective cohort study. Setting: One-hundred seventy-eight ICUs across Australia and New Zealand. Patients: All adults (≥ 17 yr) in the Australian and New Zealand Intensive Care Society Adult Patient Database between 2012 and 2017. Interventions: None. Measurements and Main Results: Among 97,181 unplanned ICU admissions from the ward, prior rapid response team review occurred in 55,084 cases (56.7%). Rapid response team patients were slightly older (65.4 [16.9] vs 63.3 [18]), had a higher Acute Physiology and Chronic Health Evaluation III score (64.6 [27.1] vs 54.7 [25.3]) and more frequently had limitations of medical treatment (13.1% vs 8.5%) compared with patients with no rapid response team review. The strongest independent associations with ICU admission following rapid response team review included age, ICU admission diagnosis (especially sepsis-, neurologic-, respiratory-, and cardiovascular-related), tertiary ICU status, and presence of limitations of medical treatment (p < 0.0001 all comparisons). Rapid response team-related ICU admissions had a longer median ICU (2.4 d [1.2–4.6 d] vs 2.1 d [1.0–4.2 d]) and hospital (12.8 d [7.0–23.6 d] vs 10.8 d [5.9–20.3 d]) length of stay, and were more likely to die in the ICU (12.3% vs 7.5%) and in-hospital (20.8% vs 13.5%) (p < 0.0001). After adjusting for illness severity and institution, patients admitted following rapid response team review stayed longer in hospital but were not at increased risk of dying in-hospital (adjusted odds ratio, 1.03; 0.98–1.07). Conclusions: In Australia and New Zealand, hospital ward patients admitted to ICU following rapid response team review represent the majority of ward-based ICU admissions, are more chronically and acutely ill, and more frequently have sepsis than those admitted from the ward without rapid response team review. Their unadjusted outcomes are worse, but after adjustment their mortality is similar.

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Elderly patients are at high risk of night‐time admission to the intensive care unit following a rapid response team call

Cited by 4 publications

References 12 publications

Night‐time detection and response in relation to deteriorating inpatients: A scoping review

Night‐time detection and response in relation to deteriorating inpatients: A scoping review

Emergency department risk factors for serious clinical deterioration in a paediatric hospital in Peru

Unplanned ICU Admission From Hospital Wards After Rapid Response Team Review in Australia and New Zealand

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