Prognostic value of the calling criteria in patients receiving a medical emergency team review

Delayed Rapid Response Team Activation Is Associated With Increased Hospital Mortality, Morbidity, and Length of Stay in a Tertiary Care Institution*

“…This may be due to several factors including improved ratio of staff during the day, different vital sign routines during the day compared with the night, concern about disturbing patients at night, as well as the availability of the primary teams who are familiar with the patient's baseline status, and therefore recognize deterioration. Several other studies have also noted a similar circadian pattern of RRT activation, with fewer calls between midnight and 6 am (24,25).…”

“…Median (IQR) Charlson scores were also the same in the no-delay and delay groups. CART scores differed, with those in the no-delay group having a median (IQR) CART score of 9 (4-17) versus a median CART score of 13 (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) for those with a delay.…”

“…The median (IQR) Charlson scores were 3 in both groups. Notable baseline differences included median (IQR) CART scores of 9 (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) in the no-delay group versus median (IQR) CART scores of 17 (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26) in the delay group. Within the no-delay group, the most common reason for RRT activation was heart rate abnormalities at 35% (149/422).…”

The rapid response system and end-of-life care

“…In a study of 1051 RRT calls in a Brazilian hospital, only 8.4% of calls had a DNR/NFR order, approximately one-third of which were written after the RRT call [31]. A study of three Canadian teaching hospitals revealed that 8.9% of RRT consults had a prior LOMT.…”

Resuscitation 2010 in review

“…A retrospective single centre study from Brazil reported the prognostic value of calling criteria in patients receiving a medical emergency team (MET) review. 11 There were 1051 calls for 901 ward patients and 423 (46.9%) died within 30 days. The authors comment on this worrying high mortality that could be caused by delays in activating the MET team.…”