• Journal of critical care · Oct 2023

    Association between time of day for rapid response team activation and mortality.

    • Márcio Manozzo Boniatti, Melina Silva de Loreto, Geris Mazzutti, Igor Gorski Benedetto, Josiane França John, Lia Andrade Zorzi, Marcius Conceição Prestes, Marina Verçoza Viana, Moreno Calcagnotto Dos Santos, Thais Crivellaro Dutra Buttelli, Wagner Nedel, NunesDiego Silva LeiteDSLHospital de Clínicas de Porto Alegre, 90035-903, Brazil., Guilherme Brauner Barcellos, Jeruza Lavanholi Neyeloff, Jose Miguel Dora, and Thiago Costa Lisboa.
    • Hospital de Clínicas de Porto Alegre, 90035-903, Brazil. Electronic address: mboniatti@hcpa.edu.br.
    • J Crit Care. 2023 Oct 1; 77: 154353154353.

    PurposeTo evaluate the frequency of rapid response team (RRT) calls by time of day and their association with in-hospital mortality.Materials And MethodsThis was a retrospective cohort study of all RRT calls at a tertiary teaching hospital in Porto Alegre, Brazil. Patients were categorized according to the time of initial RRT activation. Activations were classified as daytime (7:00-18:59) or nighttime (19:00-6:59). The primary outcome was in-hospital mortality rate. The secondary outcome was ICU admission within 48 h of RRT assessment.ResultsDuring the study period, 4522 patients were included in the final analysis. Cardiovascular and respiratory changes were more common causes of nighttime activation, whereas neurological and laboratory changes were more common during the daytime. The in-hospital mortality rate was 23.9% (1081/4522). Nighttime RRT calls were not associated with worse outcomes than daytime calls. However, a decrease in the number of calls was observed during nursing handover periods (7:00, 13:00 and 19:00). Two time periods were associated with increased adjusted odds for mortality: 12:00-13:00 (adjusted OR 2.277; 95% CI 1.392-3.725) and 19:00-20:00 (adjusted OR 1.873; CI 1.873; 95% 1.099-3.190).ConclusionWe found that nighttime RRT calls were not associated with worse outcomes than daytime RRT calls. However, a decrease in the number of calls and higher mortality was observed during nursing handover periods.Copyright © 2023 Elsevier Inc. All rights reserved.

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