Rapid response team activation prior to in-hospital cardiac arrest: Areas for improvements based on a national cohort studyShow others and affiliations
2023 (English)In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 193, article id 109978Article in journal (Refereed) Published
Abstract [en]
Introduction: Rapid response teams (RRTs) are designed to improve the "chain of prevention" of in-hospital cardiac arrest (IHCA). We studied the 30-day survival of patients reviewed by RRTs within 24 hours prior to IHCA, as compared to patients not reviewed by RRTs.
Methods: A nationwide cohort study based on the Swedish Registry of Cardiopulmonary Resuscitation, between January 1st, 2014, and December 31st, 2021. An explorative, hypothesis-generating additional in-depth data collection from medical records was performed in a small subgroup of general ward patients reviewed by RRTs.
Results: In all, 12,915 IHCA patients were included. RRT-reviewed patients (n = 2,058) had a lower unadjusted 30-day survival (25% vs 33%, p < 0.001), a propensity score based Odds ratio for 30-day survival of 0.92 (95% Confidence interval 0.90-0.94, p < 0.001) and were more likely to have a respiratory cause of IHCA (22% vs 15%, p < 0.001). In the subgroup (n = 82), respiratory distress was the most common RRT trigger, and 24% of the RRT reviews were delayed. Patient transfer to a higher level of care was associated with a higher 30-day survival rate (20% vs 2%, p < 0.001).
Conclusion: IHCA preceded by RRT review is associated with a lower 30-day survival rate and a greater likelihood of a respiratory cause of cardiac arrest. In the small explorative subgroup, respiratory distress was the most common RRT trigger and delayed RRT activation was frequent. Early detection of respiratory abnormalities and timely interventions may have a potential to improve outcomes in RRT-reviewed patients and prevent further progress into IHCA.
Place, publisher, year, edition, pages
2023. Vol. 193, article id 109978
Keywords [en]
In-hospital cardiac arrest, Medical Emergency Team, National Early Warning Score, Rapid response system, Rapid response team
National Category
Cardiology and Cardiovascular Disease
Research subject
The Human Perspective in Care
Identifiers
URN: urn:nbn:se:hb:diva-31275DOI: 10.1016/j.resuscitation.2023.109978ISI: 001138879100001Scopus ID: 2-s2.0-85173165981OAI: oai:DiVA.org:hb-31275DiVA, id: diva2:1826271
2024-01-112024-01-112025-02-10Bibliographically approved