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Etiology and Timing of Postoperative Rapid Response Team Activations


In this retrospective cohort study we sought to evaluate the association between the etiology and timing of rapid response team (RRT) activations in postoperative patients at a tertiary care hospital in the southeastern United States. From 2010 to 2016, there were 2,390 adult surgical inpatients with RRT activations within seven days of surgery. Using multivariable linear regression, we modeled the correlation between etiology of RRT and timing of the RRT call, as measured from the conclusion of the surgical procedure. We found that respiratory triggers were associated with an increase in time after surgical procedure to RRT of 10.6 h compared to activations due to general concern (95% CI 3.9 – 17.3) (p = 0.002). These findings may have an impact on monitoring of postoperative patients, as well as focusing interventions to better respond to clinically deteriorating patients.

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Our data contains protected health information and, therefore, is not publicly available.


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This work was supported by Robert E. Freundlich’s grants from the National Institutes of Health (1KL2TR002245 and 1K23HL148640).


This work was supported by Robert E. Freundlich’s grants from the National Institutes of Health (1KL2TR002245 and 1K23HL148640).

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Authors and Affiliations



Conceptualization: Jeremy P. Walco, Dorothee A. Mueller, Liza M. Weavind, Robert E. Freundlich; Methodology: Sameer Lakha, Robert E. Freundlich; Formal analysis and investigation: Jeremy P. Walco, Sameer Lakha, Jacob C. Clifton, Robert E. Freundlich; Writing – original draft preparation: Jeremy P. Walco, Jacob C. Clifton; Writing – review and editing: Dorothee A. Mueller, Sameer Lakha, Liza M. Weavind, Robert E. Freundlich; Funding acquisition: Robert E. Freundlich; Resources: Liza M. Weavind; Supervision: Jeremy P. Walco, Robert E. Freundlich.

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Correspondence to Jeremy P. Walco.

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Ethics approval / Consent to participate / Consent for publication

This retrospective cohort study was approved by our institution’s Human Research Protections Program (institutional review board #: 161910) with a waiver for written informed consent.

Conflicts of interest / Competing interests

Robert E. Freundlich has received grant funding and consulting fees from Medtronic and owns stock in 3 M.

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This article is part of the Topical Collection on Systems-Level Quality Improvement

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Walco, J.P., Mueller, D.A., Lakha, S. et al. Etiology and Timing of Postoperative Rapid Response Team Activations. J Med Syst 45, 82 (2021).

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  • Hospital rapid response team
  • Clinical deterioration
  • Postoperative period
  • Postoperative care
  • Observational study