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Title: Clinical outcomes of patients seen by Rapid Response Teams: A template for benchmarking international teams
Austin Authors: Bannard-Smith, Jonathan;Lighthall, Geoffrey K;Subbe, Christian P;Durham, Lesley;Welch, John;Bellomo, Rinaldo ;Jones, Daryl A 
Affiliation: Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia
Department of Anesthesia, Stanford University School of Medicine, Stanford, CA, USA
Acute, Respiratory & Critical Care Medicine, Ysbyty Gwynedd, Bangor, UK
North of England Critical Care Network, North Tyneside General Hospital, Rake Lane, North Shields, Northumberland, UK
Critical Care & Critical Care Outreach, University College London Hospitals, UK
Issue Date: Oct-2016
Date: 2016-07-11
Publication information: Resuscitation 2016; 107: 7-12
Abstract: AIM: The study was developed to characterize short-term outcomes of deteriorating ward patients triggering a Rapid Response Team (RRT), and describe variability between hospitals or groups thereof. METHODS: We performed an international prospective study of Rapid Response Team (RRT) activity over a 7-day period in February 2014. Investigators at 51 acute hospitals across Australia, Denmark, the Netherlands, USA and United Kingdom collected data on all patients triggering RRT review concerning the nature, trigger and immediate outcome of RRT review. Further follow-up at 24h following RRT review focused on patient orientated outcomes including need for admission to critical care, change in limitations of therapy and all cause mortality. RESULTS: We studied 1188 RRT activations. Derangement of vital signs as measured by the National Early Warning Score (NEWS) was more common in non-UK hospitals (p=0.03). Twenty four hour mortality after RRT review was 10.1% (120/1188). Urgent transfer to ICU or the operating theatre occurred in 24% (284/1188) and 3% (40/1188) of events, respectively. Patients in the UK were less likely to be admitted to ICU (31% vs. 22%; p=0.017) and their median (IQR) time to ICU admission was longer [4.4 (2.0-11.8) vs. 1.5 (0.8-4.4)h; p<0.001]. RRT involvement lead to new limitations in care in 28% of the patients not transferring to the ICU; in the UK such limitations were instituted in 21% of patients while this occurred in 40% of non-UK patients (p<0.001). CONCLUSION: Among patients triggering RRT review, 1 in 10 died within 24h; 1 in 4 required ICU admission, and 1 in 4 had new limitations in therapy implemented. We provide a template for an international comparison of outcomes at RRT level.
DOI: 10.1016/j.resuscitation.2016.07.001
Journal: Resuscitation
PubMed URL:
Type: Journal Article
Subjects: Acute illness
Critical care outreach
Early warning score
Medical emergency teams
Rapid Response Teams
Appears in Collections:Journal articles

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