期刊
RESUSCITATION
卷 85, 期 9, 页码 1275-1281出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.resuscitation.2014.06.003
关键词
Rapid response systems; Rapid response team; Medical emergency team; Cardiac arrests; Unexpected deaths; Hospital mortality
资金
- National Health and Medical Research Council (NHMRC), Australia [1020660, 1009916]
Aims: To compare clinical outcomes between a teaching hospital with a mature rapid response system (RRS), with three similar teaching hospitals without a RRS in Sydney, Australia. Methods: For the period 2002-2009, we compared a teaching hospital with a mature RRS, with three similar teaching hospitals without a RRS. Two non-RRS hospitals began implementing the system in 2009 and a third in January 2010. We compared the rates of in-hospital cardiopulmonary arrest (IHCA), IHCA-related mortality, overall hospital mortality and 1-year post discharge mortality after IHCA between the RRS hospital and the non-RRS hospitals based on three separate analyses: (1) pooled analysis during 2002-2008; (2) before-after difference between 2008 and 2009; (3) after implementation in 2009. Results: During the 2002-2008 period, the mature RRS hospital had a greater than 50% lower IHCA rate, a 40% lower IHCA-related mortality, and 6% lower overall hospital mortality. Compared to 2008, in their first year of RRS (2009) two hospitals achieved a 22% reduction in IHCA rate, a 22% reduction in IHCA-related mortality and an 11% reduction in overall hospital mortality. During the same time, the mature RRS hospital showed no significant change in those outcomes but, in 2009, it still achieved a crude 20% lower IHCA rate, and a 14% lower overall hospital mortality rate. There was no significant difference in 1-year post-discharge mortality for survivors of IHCA over the study period. Conclusions: Implementation of a RRS was associated with a significant reduction in IHCA, IHCA-related mortality and overall hospital mortality. Crown Copyright (C) 2014 Published by Elsevier Ireland Ltd. All rights reserved.
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