Quach Jon L, Downey Andrew W, Haase Michael, Haase-Fielitz Anja, Jones Daryl, Bellomo Rinaldo
Department of Intensive Care, Austin Hospital, University of Melbourne, Heidelberg, Victoria 3084, Australia.
J Crit Care. 2008 Sep;23(3):325-31. doi: 10.1016/j.jcrc.2007.11.002. Epub 2008 Apr 18.
To describe the characteristics and outcomes of patients receiving a medical emergency team (MET) review for the MET syndromes of respiratory distress or hypotension and to assess the effect of delayed MET activation on their outcomes.
We retrospectively analyzed the medical records of 2 cohorts of 100 patients for each of the MET syndromes of respiratory distress and hypotension. We collected information on patient demographics, comorbidities, presence of sepsis, and patient outcome. We documented the presence and duration of delayed MET activation.
Patients with respiratory distress were more likely to be postoperative (40% vs 28%, P = .07), but less likely to have a history of congestive cardiac failure (12% vs 22%, P = .06). Sepsis was present in 58% of cases. The hospital mortality for MET calls due to respiratory distress and hypotension was 38% and 35%, respectively (P = .77). Delayed MET calls occurred in 50% of patients with the MET syndrome of respiratory distress and in 39% of those with hypotension (P = .11). The median duration of delay was 12 hours in patients with respiratory distress compared to 5 hours for patients with hypotension (P = .016). A delay in making a MET call was associated with an increase in mortality (odds ratio, 2.10; 95% confidence interval, 1.01-4.34; P = .045).
Patients receiving MET calls for respiratory distress or hypotension were elderly and had a mortality greater than 35%. In many cases, MET activation was delayed. This delay was associated with increased mortality.
描述因呼吸窘迫或低血压等医疗急救团队（MET）综合征接受MET评估的患者的特征及结局，并评估延迟启动MET对其结局的影响。
我们回顾性分析了两组各100例因呼吸窘迫和低血压这两种MET综合征患者的病历。我们收集了患者人口统计学信息、合并症、脓毒症情况及患者结局。我们记录了延迟启动MET的情况及持续时间。
呼吸窘迫患者更可能处于术后状态（40%对28%，P = 0.07），但充血性心力衰竭病史的可能性较小（12%对22%，P = 0.06）。58%的病例存在脓毒症。因呼吸窘迫和低血压呼叫MET的患者的医院死亡率分别为38%和35%（P = 0.77）。50%的呼吸窘迫MET综合征患者和39%的低血压患者出现了延迟呼叫MET的情况（P = 0.11）。呼吸窘迫患者延迟呼叫的中位持续时间为12小时，而低血压患者为5小时（P = 0.016）。延迟呼叫MET与死亡率增加相关（比值比，2.10；95%置信区间，1.01 - 4.34；P = 0.045）。
因呼吸窘迫或低血压呼叫MET的患者年龄较大，死亡率超过35%。在许多情况下，MET的启动被延迟。这种延迟与死亡率增加相关。
