Mezzaroba Ana Luiza, Tanita Marcos Toshiyuki, Festti Josiane, Carrilho Claudia Maria Dantas de Maio, Cardoso Lucienne Tibery Queiroz, Grion Cintia Magalhães Carvalho
Universidade Estadual de Londrina, Londrina, PR, Brazil.
Rev Bras Ter Intensiva. 2016 Sep;28(3):278-284. doi: 10.5935/0103-507X.20160045. Epub 2016 Sep 9.
To evaluate the implementation of a multidisciplinary rapid response team led by an intensive care physician at a university hospital.
This retrospective cohort study analyzed assessment forms that were completed during the assessments made by the rapid response team of a university hospital between March 2009 and February 2014.
Data were collected from 1,628 assessments performed by the rapid response team for 1,024 patients and included 1,423 code yellow events and 205 code blue events. The number of assessments was higher in the first year of operation of the rapid response team. The multivariate analysis indicated that age (OR 1.02; 95%CI 1.02 - 1.03; p < 0.001), being male (OR 1.48; 95%CI 1.09 - 2.01; p = 0.01), having more than one assessment (OR 3.31; 95%CI, 2.32 - 4.71; p < 0.001), hospitalization for clinical care (OR 1.77; 95%CI 1.29 - 2.42; p < 0.001), the request of admission to the intensive care unit after the code event (OR 4.75; 95%CI 3.43 - 6.59; p < 0.001), and admission to the intensive care unit before the code event (OR 2.13; 95%CI 1.41 - 3.21; p = 0.001) were risk factors for hospital mortality in patients who were seen for code yellow events.
The hospital mortality rates were higher than those found in previous studies. The number of assessments was higher in the first year of operation of the rapid response team. Moreover, hospital mortality was higher among patients admitted for clinical care.
评估大学医院中由重症监护医师领导的多学科快速反应团队的实施情况。
这项回顾性队列研究分析了大学医院快速反应团队在2009年3月至2014年2月期间进行评估时填写的评估表。
收集了快速反应团队对1024例患者进行的1628次评估数据，包括1423次黄色代码事件和205次蓝色代码事件。快速反应团队运作的第一年评估次数较多。多变量分析表明，年龄（比值比1.02；95%置信区间1.02 - 1.03；p < 0.001）、男性（比值比1.48；95%置信区间1.09 - 2.01；p = 0.01）、接受不止一次评估（比值比3.31；95%置信区间2.32 - 4.71；p < 0.001）、因临床护理住院（比值比1.77；95%置信区间1.29 - 2.42；p < 0.001）、代码事件后入住重症监护病房的请求（比值比4.75；95%置信区间3.43 - 6.59；p < 0.001）以及代码事件前入住重症监护病房（比值比2.13；95%置信区间1.41 - 3.21；p = 0.001）是黄色代码事件患者医院死亡的危险因素。
医院死亡率高于先前研究中的死亡率。快速反应团队运作的第一年评估次数较多。此外，因临床护理入院的患者医院死亡率较高。
