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Author Smith, Roger J. ♦ Santamaria, John D. ♦ Faraone, Espedito E. ♦ Holmes, Jennifer A. ♦ Reid, David A. ♦ Tobin, Antony E.
Source World Health Organization (WHO)-Global Index Medicus
Content type Text
Publisher Elsevier
File Format HTM / HTML
Language English
Difficulty Level Medium
Subject Domain (in DDC) Social sciences ♦ Social problems & services; associations ♦ Social welfare problems & services ♦ Natural sciences & mathematics ♦ Life sciences; biology ♦ Physiology & related subjects ♦ Natural history of organisms ♦ Technology ♦ Medicine & health ♦ Human physiology ♦ Pharmacology and therapeutics ♦ Diseases ♦ Management & auxiliary services ♦ General management ♦ Manufacture for specific uses ♦ Precision instruments & other devices
Subject Domain (in MeSH) Eukaryota ♦ Organisms ♦ Respiratory Tract Diseases ♦ Cardiovascular Diseases ♦ Pathological Conditions, Signs and Symptoms ♦ Diseases ♦ Therapeutics ♦ Investigative Techniques ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment ♦ Physical Phenomena ♦ Biological Sciences ♦ Persons ♦ Persons ♦ Health Services Administration ♦ Health Care
Subject Keyword Discipline Critical Care ♦ Heart Arrest ♦ Therapy ♦ Hospital Rapid Response Team ♦ Statistics & Numerical Data ♦ Length Of Stay ♦ Respiratory Distress Syndrome, Adult ♦ Aged ♦ Aged, 80 And Over ♦ Cohort Studies ♦ Critical Illness ♦ Female ♦ Hospital Mortality ♦ Hospitalization ♦ Humans ♦ Male ♦ Middle Aged ♦ Resuscitation Orders ♦ Retrospective Studies ♦ Time Factors ♦ Journal Article
Abstract PURPOSE: The purpose of this study is to compare cases of rapid response team (RRT) review for early deterioration (<48 hours after admission), intermediate deterioration (48 to <168 hours after admission), late deterioration (≥168 hours after admission), and cardiac arrest and to determine the association between duration of hospitalization before RRT review and mortality. METHODS: This is a retrospective cohort study of RRT cases from a single hospital over 5 years (2009-2013) using administrative data and data for the first RRT attendance of each hospital episode. RESULTS: Of 2843 RRT cases, 971 (34.2%) were early deterioration, 917 (32.3%) intermediate, 775 (27.3%) late, and 180 (6.3%) cardiac arrest. Compared with early deterioration patients, late deterioration patients were older (median, 71 vs 69 years; P = .005), had a higher Charlson comorbidity index (median, 2 vs 1; P < .001), more often had RRT review for respiratory distress (32.5% vs 23.5%; P < .001), more often received RRT-initiated not for resuscitation orders (8.4% vs 3.9%; P < .001), less often were discharged directly home (27.9% vs 58.4%; P < .001), and more often died in hospital (30.6% vs 12.8%; P < .001). Compared with early deterioration and adjusted for confounders, the odds ratio of death in hospital for late deterioration was 2.36 (1.81-3.08; P < .001). CONCLUSIONS: Late deterioration is frequently encountered by the RRT and, compared with early deterioration, is associated with greater clinical complexity and a worse hospital outcome.
Description Author Affiliation: Smith RJ ( Department of Critical Care Medicine, St Vincent's Hospital, Melbourne, Australia. Electronic address: roger.smith@svha.org.au.); Santamaria JD ( Department of Critical Care Medicine, St Vincent's Hospital, Melbourne, Australia. Electronic address: john.santamaria@svha.org.au.); Faraone EE ( Department of Critical Care Medicine, St Vincent's Hospital, Melbourne, Australia. Electronic address: espedito.faraone@svha.org.au.); Holmes JA ( Department of Critical Care Medicine, St Vincent's Hospital, Melbourne, Australia. Electronic address: jennifer.holmes@svha.org.au.); Reid DA ( Department of Critical Care Medicine, St Vincent's Hospital, Melbourne, Australia. Electronic address: david.reid@svha.org.au.); Tobin AE ( Department of Critical Care Medicine, St Vincent's Hospital, Melbourne, Australia. Electronic address: antony.tobin@svha.org.au.)
ISSN 08839441
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Reading ♦ Research ♦ Self Learning
Interactivity Type Expositive
Education Level UG and PG
Learning Resource Type Article
Publisher Date 2015-08-01
Publisher Place United States
e-ISSN 15578615
Journal Journal of Critical Care
Volume Number 30
Issue Number 4


Source: WHO-Global Index Medicus