Jack Chen1, Lixin Ou2, Ken Hillman2, Arthas Flabouris3, Rinaldo Bellomo4, Stephanie J Hollis2, Hassan Assareh2. 1. Simpson Centre for Health Services Research, Australian Institute of Health Innovation & South Western Clinical School, University of New South Wales, Sydney, New South Wales, Australia. Electronic address: jackchen@unsw.edu.au. 2. Simpson Centre for Health Services Research, Australian Institute of Health Innovation & South Western Clinical School, University of New South Wales, Sydney, New South Wales, Australia. 3. Intensive Care Unit, Royal Adelaide Hospital and School of Medicine, Faculty of Health Science, University of Adelaide, Adelaide, South Australia, Australia. 4. Intensive Care Unit, Austin Medical Centre, Melbourne, Victoria, Australia.
Abstract
AIMS: To compare clinical outcomes between a teaching hospital with a mature rapid response system (RRS), with three similar teaching hospitals without a RRS in Sydney, Australia. METHODS: For the period 2002-2009, we compared a teaching hospital with a mature RRS, with three similar teaching hospitals without a RRS. Two non-RRS hospitals began implementing the system in 2009 and a third in January 2010. We compared the rates of in-hospital cardiopulmonary arrest (IHCA), IHCA-related mortality, overall hospital mortality and 1-year post discharge mortality after IHCA between the RRS hospital and the non-RRS hospitals based on three separate analyses: (1) pooled analysis during 2002-2008; (2) before-after difference between 2008 and 2009; (3) after implementation in 2009. RESULTS: During the 2002-2008 period, the mature RRS hospital had a greater than 50% lower IHCA rate, a 40% lower IHCA-related mortality, and 6% lower overall hospital mortality. Compared to 2008, in their first year of RRS (2009) two hospitals achieved a 22% reduction in IHCA rate, a 22% reduction in IHCA-related mortality and an 11% reduction in overall hospital mortality. During the same time, the mature RRS hospital showed no significant change in those outcomes but, in 2009, it still achieved a crude 20% lower IHCA rate, and a 14% lower overall hospital mortality rate. There was no significant difference in 1-year post-discharge mortality for survivors of IHCA over the study period. CONCLUSIONS: Implementation of a RRS was associated with a significant reduction in IHCA, IHCA-related mortality and overall hospital mortality. Crown
AIMS: To compare clinical outcomes between a teaching hospital with a mature rapid response system (RRS), with three similar teaching hospitals without a RRS in Sydney, Australia. METHODS: For the period 2002-2009, we compared a teaching hospital with a mature RRS, with three similar teaching hospitals without a RRS. Two non-RRS hospitals began implementing the system in 2009 and a third in January 2010. We compared the rates of in-hospital cardiopulmonary arrest (IHCA), IHCA-related mortality, overall hospital mortality and 1-year post discharge mortality after IHCA between the RRS hospital and the non-RRS hospitals based on three separate analyses: (1) pooled analysis during 2002-2008; (2) before-after difference between 2008 and 2009; (3) after implementation in 2009. RESULTS: During the 2002-2008 period, the mature RRS hospital had a greater than 50% lower IHCA rate, a 40% lower IHCA-related mortality, and 6% lower overall hospital mortality. Compared to 2008, in their first year of RRS (2009) two hospitals achieved a 22% reduction in IHCA rate, a 22% reduction in IHCA-related mortality and an 11% reduction in overall hospital mortality. During the same time, the mature RRS hospital showed no significant change in those outcomes but, in 2009, it still achieved a crude 20% lower IHCA rate, and a 14% lower overall hospital mortality rate. There was no significant difference in 1-year post-discharge mortality for survivors of IHCA over the study period. CONCLUSIONS: Implementation of a RRS was associated with a significant reduction in IHCA, IHCA-related mortality and overall hospital mortality. Crown
Authors: Ana Luiza Mezzaroba; Marcos Toshiyuki Tanita; Josiane Festti; Claudia Maria Dantas de Maio Carrilho; Lucienne Tibery Queiroz Cardoso; Cintia Magalhães Carvalho Grion Journal: Rev Bras Ter Intensiva Date: 2016-09-09