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KMID : 1144420190340040246
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Acute and Critical Care
2019 Volume.34 No. 4 p.246 ~ p.254
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Effect of a rapid response system on code rates and in-hospital mortality in medical wards
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Lee Hong-Yeul
Lee Jin-Woo
Lee Sang-Min
Kim Sul-Hee
Yang Eun-Jin
Lee Hyun-Joo
Lee Han-Nah
Ryu Ho-Geol
Oh Seung-Young
Ha Eun-Jin
Ko Sang-Bae
Cho Jae-Young
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Abstract
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Background: To determine the effects of implementing a rapid response system (RRS) on code rates and in-hospital mortality in medical wards.
Methods: This retrospective study included adult patients admitted to medical wards at Seoul National University Hospital between July 12, 2016 and March 12, 2018; the sample comprised 4,224 patients admitted 10 months before RRS implementation and 4,168 patients admitted 10 months following RRS implementation. Our RRS only worked during the daytime (7 AM to 7 PM) on weekdays. We compared code rates and in-hospital mortality rates between the preintervention and postintervention groups.
Results: There were 62.3 RRS activations per 1,000 admissions. The most common reasons for RRS activation were tachypnea or hypopnea (44%), hypoxia (31%), and tachycardia or bradycardia (21%). Code rates from medical wards during RRS operating times significantly decreased from 3.55 to 0.96 per 1,000 admissions (adjusted odds ratio [aOR], 0.29; 95% confidence interval [CI], 0.10 to 0.87; P=0.028) after RRS implementation. However, code rates from medical wards during RRS nonoperating times did not differ between the preintervention and postintervention groups (2.60 vs. 3.12 per 1,000 admissions; aOR, 1.23; 95% CI, 0.55 to 2.76; P=0.614). In-hospital mortality significantly decreased from 56.3 to 42.7 per 1,000 admissions after RRS implementation (aOR, 0.79; 95% CI, 0.64 to 0.97; P=0.024).
Conclusions: Implementation of an RRS was associated with significant reductions in code rates during RRS operating times and in-hospital mortality in medical wards.
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KEYWORD
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cardiopulmonary resuscitation, hospital mortality, hospital rapid response team, internal medicine
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