Intensive Care Medicine

, 34:2112

A prospective study of factors influencing the outcome of patients after a Medical Emergency Team review

  • Paolo Calzavacca
  • Elisa Licari
  • Augustine Tee
  • Moritoki Egi
  • Michael Haase
  • Anja Haase-Fielitz
  • Rinaldo Bellomo
Brief Report

DOI: 10.1007/s00134-008-1229-y

Cite this article as:
Calzavacca, P., Licari, E., Tee, A. et al. Intensive Care Med (2008) 34: 2112. doi:10.1007/s00134-008-1229-y

Abstract

Objective

To identify factors that predict outcome in patients receiving a Medical Emergency Team review.

Design

Prospective observational study.

Setting

Tertiary hospital.

Patients

Cohort of 228 patients receiving one or more Medical Emergency Team reviews during daytime hours over a 1-year-period. Control cohort of all patients (n = 900) receiving a Medical Emergency Team review in the same period.

Measurements and results

We prospectively collected information from patients receiving a Medical Emergency Team review during daytime hours from Monday to Friday (audit group) including the clinical cause of deterioration and timing of call in relation to the first documented Medical Emergency Team call criterion (activation delay). We also collected information from the hospital Medical Emergency Team database regarding all patients visited by the Medical Emergency Team during the same period (complete cohort). Audit group patients had several similar characteristics to complete cohort patients but were less likely to be not-for-resuscitation before Medical Emergency Team review and more likely to receive a Medical Emergency Team review because of hypotension, change in neurological status and oliguria. Delayed Medical Emergency Team activation and not-for resuscitation orders were the only factors to show an independent statistical association with mortality (OR 2.53, 95% CI: 1.2–5.31, P = 0.01 and OR 5.63, 95% CI: 2.81–11.28, P < 0.01, respectively).

Conclusion

Delayed Medical Emergency Team activation and NFR orders are the strongest independent predictors of mortality in patients receiving a Medical Emergency Team review. Avoidance of delayed Medical Emergency Team activation should be a priority for hospitals operating rapid response systems.

Keywords

Medical Emergency Team Rapid response system Critical illness Vital signs Mortality 

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Paolo Calzavacca
    • 1
  • Elisa Licari
    • 1
  • Augustine Tee
    • 1
  • Moritoki Egi
    • 1
  • Michael Haase
    • 1
  • Anja Haase-Fielitz
    • 1
  • Rinaldo Bellomo
    • 1
  1. 1.Department of Intensive Care and Department of MedicineAustin HospitalMelbourneAustralia

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