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KMID : 0191120210360020007
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Journal of Korean Medical Science
2021 Volume.36 No. 2 p.7 ~ p.7
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Rapid Response System Should Be Enhanced at Non-general Ward Locations: a Retrospective Multicenter Cohort Study in Korea
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Kang Byung-Ju
Hong Sang-Bum
Jeon Kyeong-Man
Lee Sang-Min
Lee Dong-Hyun
Moon Jae-Young
Lee Yeon-Joo
Kim Jung-Soo
Park Ji-Soo
Ahn Jong-Joon
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Abstract
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Background: A rapid response system (RRS) contributes to the safety of hospitalized patients. Clinical deterioration may occur in the general ward (GW) or in non-GW locations such as radiology or dialysis units. However, there are few studies regarding RRS activation in non-GW locations. This study aimed to compare the clinical characteristics and outcomes of patients with RRS activation in non-GW locations and in the GW.
Methods: From January 2016 to December 2017, all patients requiring RRS activation in nine South Korean hospitals were retrospectively enrolled and classified according to RRS activation location: GW vs non-GW RRS activations.
Results: In total, 12,793 patients were enrolled; 222 (1.7%) were non-GW RRS activations. There were more instances of shock (11.6% vs. 18.5%) and cardiac arrest (2.7% vs. 22.5%) in non-GW RRS activation patients. These patients also had a lower oxygen saturation (92.6% ± 8.6% vs. 88.7% ± 14.3%, P < 0.001) and a higher National Early Warning Score 2 (7.5 ± 3.4 vs. 8.9 ± 3.8, P < 0.001) than GW RRS activation patients. Although non-GW RRS activation patients received more intubation (odds ratio [OR], 3.135; P < 0.001), advanced cardiovascular life support (OR, 3.912; P < 0.001), and intensive care unit transfer (OR, 2.502; P < 0.001), their hospital mortality (hazard ratio, 0.630; P = 0.013) was lower than GW RRS activation patients upon multivariate analysis.
Conclusion: Considering that there were more critically ill but recoverable cases in non-GW locations, active RRS involvement should be required in such locations.
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KEYWORD
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Heart Arrest, Hospital Rapid Response Team, Intensive Care Units, Patients' Rooms, Shock
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