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Effectiveness of a daytime rapid response system in hospitalized surgical ward patients

Cited 6 time in Web of Science Cited 8 time in Scopus
Authors

Yang, Eunjin; Lee, Hannah; Lee, Sang-Min; Kim, Sulhee; Ryu, Ho Geol; Lee, Hyun Joo; Lee, Jinwoo; Oh, Seung-Young

Issue Date
2020-05
Publisher
대한중환자의학회
Citation
Acute and Critical Care, Vol.35 No.2, pp.77-86
Abstract
Background: Clinical deteriorations during hospitalization are often preventable with a rapid response system (RRS). We aimed to investigate the effectiveness of a daytime RRS for surgical hospitalized patients. Methods: A retrospective cohort study was conducted in 20 general surgical wards at a 1,779-bed University hospital from August 2013 to July 2017 (August 2013 to July 2015, pre-RRS-period; August 2015 to July 2017, post-RRS-period). The primary outcome was incidence of cardiopulmonary arrest (CPA) when the RRS was operating. The secondary outcomes were the incidence of total and preventable cardiopulmonary arrest, in-hospital mortality, the percentage of "do not resuscitate" orders, and the survival of discharged CPA patients. Results: The relative risk (RR) of CPA per 1,000 admissions during RRS operational hours (weekdays from 7 AM to 7 PM) in the post-RRS-period compared to the pre-RRS-period was 0.53 (95% confidence interval [CI], 0.25 to 1.13; P=0.099) and the RR of total CPA regardless of RRS operating hours was 0.76 (95% CI, 0.46 to 1.28; P=0.301). The preventable CPA after RRS implementation was significantly lower than that before RRS implementation (RR, 0.31; 95% CI, 0.11 to 0.88; P=0.028). There were no statistical differences in in-hospital mortality and the survival rate of patients with in-hospital cardiac arrest. Do-not-resuscitate decisions significantly increased during after RRS implementation periods compared to pre-RRS periods (RR, 1.91; 95% CI, 1.40 to 2.59; P<0.001). Conclusions: The day-time implementation of the RRS did not significantly reduce the rate of CPA whereas the system effectively reduced the rate of preventable CPA during periods when the system was operating.
ISSN
2586-6052
URI
https://hdl.handle.net/10371/177926
DOI
https://doi.org/10.4266/acc.2019.00661
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Medicine (의학과)Journal Papers (저널논문_의학과)
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