利用医疗急救团队反应来减少医院心肺骤停情况。
Use of medical emergency team responses to reduce hospital cardiopulmonary arrests.
作者信息
DeVita M A, Braithwaite R S, Mahidhara R, Stuart S, Foraida M, Simmons R L
机构信息
200 Lothrop Street, Pittsburgh, PA 15213, USA.
出版信息
Qual Saf Health Care. 2004 Aug;13(4):251-4. doi: 10.1136/qhc.13.4.251.
BACKGROUND
Medical emergency team (MET) responses have been implemented to reduce inpatient mortality, but data on their efficacy are sparse and there have been no reports to date from US hospitals.
OBJECTIVES
To determine how the incidence and outcomes of cardiac arrests have changed following increased use of MET.
METHODS
Objective criteria for MET activation were created and disseminated as part of a crisis management program, after which there was a rapid and sustained increase in the use of MET. A retrospective analysis of clinical outcomes was performed to compare the incidence and mortality of cardiopulmonary arrest before and after the increased use of MET.
RESULTS
A retrospective analysis of 3269 MET responses and 1220 cardiopulmonary arrests over 6.8 years showed an increase in MET responses from 13.7 to 25.8 per 1000 admissions (p<0.0001) after instituting objective activation criteria. There was a coincident 17% decrease in the incidence of cardiopulmonary arrests from 6.5 to 5.4 per 1000 admissions (p = 0.016). The proportion of fatal arrests was similar before and after the increase in use of MET.
CONCLUSIONS
Increased use of MET may be associated with fewer cardiopulmonary arrests.
背景
已实施医疗急救团队（MET）响应措施以降低住院患者死亡率，但关于其疗效的数据稀少，且美国医院至今尚无相关报告。
目的
确定在增加使用MET后心脏骤停的发生率和结局如何变化。
方法
制定并传播MET激活的客观标准，作为危机管理计划的一部分，此后MET的使用迅速且持续增加。对临床结局进行回顾性分析，以比较增加使用MET前后心肺骤停的发生率和死亡率。
结果
对6.8年期间3269次MET响应和1220次心肺骤停进行的回顾性分析显示，在制定客观激活标准后，MET响应从每1000例入院患者13.7次增加到25.8次（p<0.0001）。心肺骤停的发生率同时下降了17%，从每1000例入院患者6.5次降至5.4次（p = 0.016）。MET使用增加前后致命性骤停的比例相似。
结论
增加使用MET可能与更少的心肺骤停相关。
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