Utilization of a rapid response team and associated outcomes in patients with malignancy

Abstract

Utilization of a rapid response team and associated outcomes in patients with malignancy Background: Recent advances in diagnosis and treatment have improved long-term outcomes in cancer patients. As a result, the requirement for a rapid response team (RRT) for cancer patients is also increasing. This study aimed to analyze utilization of an RRT and the associations between related factors and mortality in a population of cancer patients. Methods: This retrospective cohort study included hospitalized patients at a single academic medical center in Seoul, Korea, who required RRT activation during a 6-year period from June 2013 to December 2018. Results: Overall, 164 of the 457 patients who met the above criteria were cancer patients, and they had a significantly higher Charlson comorbidity score than the non-cancer patients (5.0 vs. 7.0, P < 0.001). A significantly larger proportion of cancer patients required intensive care unit transfer (51.8% vs. 41.0%, P = 0.032). Cancer patients also had significantly higher in-hospital mortality compared with other patients (39.6% vs. 10.9%, P < 0.001). Furthermore, presence of cancer was independently associated with in-hospital mortality (adjusted odds ratio [OR], 2.09; 95% confidence interval [CI], 1.11 to 3.93). Among cancer patients, higher Acute Physiology and Chronic Health Evaluation (APACHE) II at the time of RRT activation was significantly associated with in-hospital mortality regardless of malignancy (adjusted OR, 1.08; 95% CI, 1.01 to 1.15). Conclusions: Cancer patients requiring RRT activation have significantly higher rates of inhospital mortality than patients not using RRT. Higher severity score at the time of RRT activation in patients with malignancy was significantly associated with in-hospital mortality.

Characteristics and outcomes of patients screened by rapid response team who transferred to the intensive care unit

“…In a study by Shappell et al, among the deceased patients screened by RRT, more patients were older (median age 72 vs. 66 years), were admitted for non-cardiac medical illness (70% vs. 58%), and had a greater median LOS before RRT screening (81 vs. 47 h) [ 39 ]. In a study by Lee et al, the presence of malignancy was independently associated with in-hospital mortality [ 40 ]. Therefore, more careful treatment when patients with these conditions are screened by RRT may help improve patient prognosis.…”

Outcomes of second-tier rapid response activations in a tertiary referral hospital: A prospective observational study

“…In addition, metastatic cancer and haematological cancer as comorbidities were significantly associated with mortality, independent of age, performance status and physiological deterioration based on NEWS. In patients with cancer, reported in-hospital mortality after RRT activations were 33-40%, [28][29][30] with mortality rates as high as 42% demonstrated in patients with haematological cancer. 31 Clearly, patients with cancer were at a high risk of dying, especially so if RRT activations were required.…”

Novel Adaptive T-Cell Oncological Treatments Lead to New Challenges for Medical Emergency Teams: A 2-Year Experience From a Tertiary-Care Hospital in Switzerland

“…Yet, only few studies evaluated MET interventions in the population of cancer patients. Current data suggest that cancer patients requiring MET activation, particularly when the patient needs ICU admission, have higher inhospital mortality and use up more MET resources than noncancer patients (9, 10). It has been reported that up to 40% of patients undergoing CAR T-cell therapy require ICU admission (8, 11).…”