Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/13721
Title: Physiological status during emergency department care: Relationship with inhospital death after clinical deterioration
Authors: Considine, J;Jones, D;Pilcher, D;Currey, J
Issue Date: Dec-2015
Citation: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine 2015, vol.17(4) p. 257-62
Abstract: OBJECTIVE: To examine the relationship between patient physiological status in the emergency department (ED) and inhospital mortality after rapid response team (RRT) or cardiac arrest team (CAT) activations within 72 hours of emergency admission to medical or surgical wards. DESIGN, SETTING AND PARTICIPANTS: A multisite, retrospective, cohort study of 660 randomly selected (220 patients per site) adult medical or surgical patients who were admitted from the ED during 2012 and who had had an RRT or CAT activation within 72 hours of admission, at three hospitals in Melbourne, Australia. MAIN OUTCOME MEASURE: Inhospital mortality. RESULTS: There were 825 RRT activations (for 634 patients) and 42 CAT activations (for 35 patients). The median time to the first RRT or CAT activation was 18.8 hours and was significantly shorter in patients who died in hospital (14.6 v 20.6 hours, P=0.036). Compared with survivors, patients who died were more likely to have at least one observation meeting RRT criteria during their ED stay (45.9% v 34.8%; P=0.029): tachypnoea (21.1% v 13.4%, P=0.039), hypotension (20.2% v 11.8%, P=0.018), hypoxaemia (8.3% v 3.1%, P=0.001) and altered conscious state (6.2% v 1.3%, P=0.001) were more common in patients who died. The risk-adjusted odds ratio (OR) for inhospital death was highest for patients with an altered conscious state during their ED stay (OR, 4.633; 95% CI, 1.365-15.728; P=0.014). CONCLUSIONS: In patients who needed an RRT or CAT activation within the first 72 hours of emergency admission to medical or surgical wards, there was a strong association between physiological derangement during ED care and inhospital death.
URI: http://ahro.austin.org.au/austinjspui/handle/1/13721
PubMed URL: http://www.ncbi.nlm.nih.gov/pubmed/26640061
Type: Journal Article
Subjects: Emergency Medical Services
Hospital Rapid Response Team
Retrospective Studies
Hospital Mortality
Heart Arrest
Type of Clinical Study or Trial: Multicentre Studies
Appears in Collections:Journal articles

Files in This Item:
There are no files associated with this item.


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.