• Crit Care Resusc · Sep 2011

    Medical reviews before cardiac arrest, medical emergency call or unanticipated intensive care unit admission: their nature and impact on patient outcome.

    • Rebecca M Trinkle and Arthas Flabouris.
    • Royal Adelaide Hospital, Adelaide, SA, Australia.
    • Crit Care Resusc. 2011 Sep 1;13(3):175-80.

    ObjectiveTo measure and describe the extent and consequences of documented medical patient reviews in the 24 hours before a cardiac arrest, medical emergency team (MET) call or an unanticipated intensive care unit admission ("event"), and the use of such reviews as a rapid response system performance measure.DesignRetrospective case-note and database review.SettingTertiary referral hospital, April-September, 2008.ParticipantsAdult inpatients who had an event and a preceding hospital length of stay > 24 hours.Main Outcome MeasuresHospital discharge status, ICU length of stay, not-for-resuscitation order.Results443 patients had 575 events (6.1% cardiac arrests, 68.7% MET calls, 25.2% ICU admissions) in the study period. A documented medical review preceded 561 (97.6%) events. Patients whose review was a home team review (HTR; ie, from a general ward) only were older than those with a critical care review (CCR) (70.2 v 63.6 years; P < 0.01). A critical care discharge (CCD) or CCR preceded 39.5% and HTR only, 57.9% of events. A CCD preceded 25.7% of cardiac arrests, 32.4% of MET calls, and 29.0% unanticipated ICU admissions. Patients with a CCR or CCD had lower hospital mortality than those with an HTR only (27.3% v 41.7%; P < 0.01), and shorter median ICU length of stay (2 [interquartile range, 1-3] v 2 [interquartile range, 1-6] days; P = 0.04).ConclusionsMedical reviews in the 24 hours before an adverse event are common. The type of medical review may influence patient outcome and thus may be a useful measure of rapid-response systems and critical care performance.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…