Center for Quality of Care Research, Baystate Medical Center, Springfield, MA, USA.
J Hosp Med. 2012 Feb;7(2):98-103. doi: 10.1002/jhm.953. Epub 2011 Oct 13.
The effect of Medical Emergency Teams (METs) on cardiopulmonary arrests (codes) and fatal codes remains unclear and widely debated.
To describe the implementation of a hospitalist-led MET and compare the number of code calls and code deaths before and after implementation.
Interrupted time series.
Tertiary care academic medical center.
All hospitalized patients.
Implementation of an MET, consisting of a critical care nurse, respiratory therapist, intravenous therapist, and the patient's physician.
Number of MET calls, code calls, cardiac arrests and other medical crises, and code deaths per 1000 admissions, stratified by location (inside vs outside critical care).
From implementation in March 2006 through December 2009, the MET logged 2717 calls, most commonly for respiratory distress (33%), cardiovascular instability (25%), and neurological abnormality (20%). Overall code calls declined significantly between pre-implementation and post-implementation of the MET from 7.30 (95% confidence interval [CI] 5.81, 9.16) to 4.21 (95% CI 3.42, 5.18) code calls per 1000 admissions. Outside of critical care, code calls declined from 4.70 (95% CI 3.92, 5.63) before the MET was implemented to 3.11 (95% CI 2.44, 3.97) afterwards, primarily due to a decrease in medical crises, which averaged 3.29 events per 1000 admissions (95% CI 2.70, 4.02) before implementation and decreased to 1.72 (95% CI 1.28, 2.31) afterwards. Code calls within critical care also declined. The rate of fatal codes was not affected.
A hospitalist-led MET decreased code call rates but did not affect mortality rates.
医疗急救团队（MET）对心肺骤停（代码）和致命代码的影响仍不清楚，且存在广泛争议。
描述一个由医院医生领导的 MET 的实施情况，并比较实施前后代码调用次数和代码死亡人数。
中断时间序列。
三级保健学术医疗中心。
所有住院患者。
实施由一名重症监护护士、呼吸治疗师、静脉治疗师和患者的医生组成的 MET。
每 1000 次入院的 MET 调用次数、代码调用次数、心脏骤停和其他医疗危机以及代码死亡人数，按位置（重症监护室内外）分层。
从 2006 年 3 月实施到 2009 年 12 月，MET 记录了 2717 次调用，最常见的是呼吸窘迫（33%）、心血管不稳定（25%）和神经异常（20%）。在 MET 实施前后，总体代码调用显著下降，从实施前的每 1000 次入院 7.30（95%置信区间 [CI] 5.81，9.16）降至实施后的每 1000 次入院 4.21（95% CI 3.42，5.18）。在重症监护室外，代码调用从 MET 实施前的每 1000 次入院 4.70（95% CI 3.92，5.63）下降到实施后的每 1000 次入院 3.11（95% CI 2.44，3.97），主要是由于医疗危机的减少，实施前平均每 1000 次入院有 3.29 次事件（95% CI 2.70，4.02），而实施后减少到 1.72（95% CI 1.28，2.31）。重症监护室内的代码调用也有所下降。致命代码的发生率没有受到影响。
由医院医生领导的 MET 降低了代码调用率，但没有影响死亡率。
