• Joonas Tirkkonen, Tero Tamminen, and Markus B Skrifvars.
• Department of Intensive Care Medicine, Tampere University Hospital and Department of Anaesthesiology and Intensive Care Medicine, Seinäjoki Central Hospital, P.O. Box 2000, FI-33521 Tampere, Finland. Electronic address: tirkkonen.joonas.o@student.uta.fi.
• Resuscitation. 2017 Mar 1; 112: 43-52.

BackgroundAn abundance of studies have investigated the impact of rapid response teams (RRTs) on in-hospital cardiac arrest rates. However, existing RRT data appear highly variable in terms of both study quality and reported uses of limitations of care, patient survival and patient long-term outcome.MethodsA systematic electronic literature search (January, 1990-March, 2016) of the PubMed and Cochrane databases was performed. Bibliographies of articles included in the full-text review were searched for additional studies. A predefined RRT cohort quality score (range 0-17) was used to evaluate studies independently by two reviewers.ResultsTwenty-nine studies with a total of 157,383 RRT activations were included in this review. The quality of data reporting related to RRT patients was assessed as modest, with a median quality score of 8 (range 2-11). Data from the included studies indicate that a median 8.1% of RRT reviews result in limitations of medical treatment (range 2.1-25%) and 23% (8.2-56%) result in a transfer to intensive care. A median of 29% (6.9-35%) of patients transferred to intensive care died during that admission. The median hospital mortality of patients reviewed by RRT is 26% (12-60%), and the median 30-day mortality rate is 29% (8-39%). Data on long-term survival is minimal. No data on functional outcomes was identified.ConclusionsPatients reviewed by rapid response teams have a high and variable mortality rate, and limitations of care are commonly used. Data on the long-term outcomes of RRT are lacking and needed.Copyright © 2017 Elsevier B.V. All rights reserved.

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