Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/69952
Type: Journal article
Title: Medical reviews before cardiac arrest, medical emergency call or unanticipated intensive care unit admission: their nature and impact on patient outcome
Author: Trinkle, R.
Flabouris, A.
Citation: Critical Care and Resuscitation, 2011; 13(3):175-180
Publisher: Australasian Academy of Critical Care Medicine
Issue Date: 2011
ISSN: 1441-2772
2652-9335
Statement of
Responsibility: 
Rebecca M Trinkle and Arthas Flabouris
Abstract: Objective: To measure and describe the extent and consequences of documented medical patient reviews in the 24 hours before a cardiac arrest, medical emergency team (MET) call or an unanticipated intensive care unit admission ('event'), and the use of such reviews as a rapid response system performance measure. Design: Retrospective case-note and database review. Setting: Tertiary referral hospital, April-September, 2008. Participants: Adult inpatients who had an event and a preceding hospital length of stay > 24 hours. Main outcome measures: Hospital discharge status, ICU length of stay, not-for-resuscitation order. Results: 443 patients had 575 events (6.1% cardiac arrests, 68.7% MET calls, 25.2% ICU admissions) in the study period. A documented medical review preceded 561 (97.6%) events. Patients whose review was a home team review (HTR; ie, from a general ward) only were older than those with a critical care review (CCR) (70.2 v 63.6 years; P < 0.01). A critical care discharge (CCD) or CCR preceded 39.5% and HTR only, 57.9% of events. A CCD preceded 25.7% of cardiac arrests, 32.4% of MET calls, and 29.0% unanticipated ICU admissions. Patients with a CCR or CCD had lower hospital mortality than those with an HTR only (27.3% v 41.7%; P < 0.01), and shorter median ICU length of stay (2 [interquartile range, 1-3] v 2 [interquartile range, 1-6] days; P = 0.04). Conclusions: Medical reviews in the 24 hours before an adverse event are common. The type of medical review may influence patient outcome and thus may be a useful measure of rapid-response systems and critical care performance.
Keywords: Humans
Heart Arrest
Critical Care
Hospitalization
Health Status Indicators
Retrospective Studies
Aged
Middle Aged
Intensive Care Units
Emergency Medical Services
Female
Male
Hospital Rapid Response Team
Outcome and Process Assessment, Health Care
Rights: Copyright status unknown
Published version: http://search.informit.com.au.proxy.library.adelaide.edu.au/documentSummary;dn=349344873543878;res=IELHEA
Appears in Collections:Aurora harvest
Medicine publications

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