Sachin Gupta1, Cameron Green2, Ashwin Subramaniam3, Lim Dee Zhen4, Elizabeth Low4, Ravindranath Tiruvoipati5. 1. Department of Intensive Care Medicine, Peninsula Health, Victoria, Australia; Faculty of Medicine, Nursing, and Health Sciences, Monash University, Victoria, Australia. 2. Department of Intensive Care Medicine, Peninsula Health, Victoria, Australia. Electronic address: cgreen@phcn.vic.gov.au. 3. Department of Intensive Care Medicine, Peninsula Health, Victoria, Australia; Faculty of Medicine, Nursing, and Health Sciences, Monash University, Victoria, Australia; Department of Medicine, Peninsula Health, Victoria, Australia. 4. Department of Medicine, Peninsula Health, Victoria, Australia. 5. Department of Intensive Care Medicine, Peninsula Health, Victoria, Australia; Faculty of Medicine, Nursing, and Health Sciences, Monash University, Victoria, Australia. Electronic address: rtiruvoipati@phcn.vic.gov.au.
Abstract
PURPOSE: To investigate the impact of delay in rapid response call (RRC) activation on Hospital mortality. MATERIALS AND METHODS: This study was conducted in a university affiliated hospital providing medical, surgical, mental health, maternity, and pediatric services. RRCs were considered delayed if RRC activation was delayed by ≥15min. The primary outcome measure was in-hospital mortality. Secondary outcomes included hospital length of stay (LOS), requirement of ICU admission, as well as requirement of mechanical ventilation and ICU LOS for patients requiring ICU admission. RESULTS: A total of 826 RRCs occurred in 629 patient admissions. A quarter of all RRCs were delayed by ≥15min, with a median delay of 1h and 20min. Patients with a delayed RRC had significantly higher in-hospital mortality (34.7% vs. 21.2%; p=0.001,) and significantly longer hospitalizations (11.6 vs. 8.4days; p=0.036). After adjusting for confounders, RRC activation was independently associated with increased in-hospital mortality (OR=1.79; 95% CI=1.17-2.72: p=0.007). CONCLUSIONS: A delay of ≥15min was associated with significantly increased in-hospital mortality and longer hospitalization. The factors contributing to the observed increase in mortality with delayed RRCs require further exploration.
PURPOSE: To investigate the impact of delay in rapid response call (RRC) activation on Hospital mortality. MATERIALS AND METHODS: This study was conducted in a university affiliated hospital providing medical, surgical, mental health, maternity, and pediatric services. RRCs were considered delayed if RRC activation was delayed by ≥15min. The primary outcome measure was in-hospital mortality. Secondary outcomes included hospital length of stay (LOS), requirement of ICU admission, as well as requirement of mechanical ventilation and ICU LOS for patients requiring ICU admission. RESULTS: A total of 826 RRCs occurred in 629 patient admissions. A quarter of all RRCs were delayed by ≥15min, with a median delay of 1h and 20min. Patients with a delayed RRC had significantly higher in-hospital mortality (34.7% vs. 21.2%; p=0.001,) and significantly longer hospitalizations (11.6 vs. 8.4days; p=0.036). After adjusting for confounders, RRC activation was independently associated with increased in-hospital mortality (OR=1.79; 95% CI=1.17-2.72: p=0.007). CONCLUSIONS: A delay of ≥15min was associated with significantly increased in-hospital mortality and longer hospitalization. The factors contributing to the observed increase in mortality with delayed RRCs require further exploration.
Authors: Antonio Gallo; Anna Anselmi; Francesca Locatelli; Eleonora Pedrazzoli; Roberto Petrilli; Alessandro Marcon Journal: Int J Environ Res Public Health Date: 2022-01-11 Impact factor: 3.390