Effect of a rapid response system on code rates and in-hospital mortality in medical wardsopen access
- Authors
- Lee, Hong Yeul; Lee, Jinwoo; Lee, Sang-Min; Kim, Sulhee; Yang, Eunjin; Lee, Hyun Joo; Lee, Hannah; Ryu, Ho Geol; Oh, Seung-Young; Ha, Eun Jin; Ko, Sang-Bae; Cho, Jaeyoung
- Issue Date
- Nov-2019
- Publisher
- KOREAN SOC CRITICAL CARE MEDICINE
- Keywords
- cardiopulmonary resuscitation; hospital mortality; hospital rapid response team; internal medicine
- Citation
- ACUTE AND CRITICAL CARE, v.34, no.4, pp.246 - 254
- Journal Title
- ACUTE AND CRITICAL CARE
- Volume
- 34
- Number
- 4
- Start Page
- 246
- End Page
- 254
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/87189
- DOI
- 10.4266/acc.2019.00668
- ISSN
- 2586-6052
- Abstract
- 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 NOR), 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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