• Soo Jin Na, Ryoung-Eun Ko, Myeong Gyun Ko, Ahra Koh, Chi Ryang Chung, Gee Young Suh, and Kyeongman Jeon.
• Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
• Crit. Care Med. 2020 Nov 1; 48 (11): e1029-e1037.

ObjectivesThe objective of this study was to investigate the risk factors for early medical emergency team reactivation (which is defined as repeated medical emergency team calls within 72 hr after the index medical emergency team call) in the patients remaining on the ward after index medical emergency team activation.DesignRetrospective analysis with prospectively collected data.SettingA university-affiliated, tertiary referral hospital.PatientsAll consecutive patients over 18 years old who received medical emergency team intervention.InterventionsNone.Measurements And Main ResultsOf the 3,989 cases eligible for analysis, 514 cases (12.9%) were classified into the reactivation group, with the remainder assigned to the nonreactivation group. In a multivariate analysis, chronic lung disease (odds ratio, 1.38; 95% CI, 1.03-1.86; p = 0.032), chronic liver disease (odds ratio, 1.44; 95% CI, 1.04-1.99; p = 0.028), activation due to bedside concern about overall deterioration without abnormal physiological variables (odds ratio, 1.30; 95% CI, 1.00-1.68; p = 0.049), advice or consultation only for medical emergency team intervention (odds ratio, 0.78; 95% CI, 0.63-0.97; p = 0.027), and discussion about treatment limitation (odds ratio, 0.39; 95% CI, 0.25-0.60; p < 0.001) were independently associated with medical emergency team reactivation. In the reactivation group, 249 patients (48.5%) were transferred to the ICU after repeated calls. Medical department admission (odds ratio, 1.68; 95% CI, 1.12-2.52; p = 0.012), chronic liver disease (odds ratio, 1.73; 95% CI, 1.07-2.79; p = 0.025), hematological malignancies (odds ratio, 1.63; 95% CI, 1.10-2.41; p = 0.015), and tachypnea at the end of medical emergency team were risk factors for medical emergency team reactivation requiring ICU admission. Discussion about treatment limitation (odds ratio, 0.14; 95% CI, 0.05-0.40; p < 0.001) was also associated with decreased risk of medical emergency team reactivation requiring ICU admission.ConclusionsAn increased risk of early medical emergency team reactivation was associated with medical emergency team activation by bedside concern about overall deterioration and patients with chronic lung or liver disease.

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