Tirkkonen Joonas, Tamminen Tero, Skrifvars Markus B
Department of Intensive Care Medicine, Tampere University Hospital and Department of Anaesthesiology and Intensive Care Medicine, Seinäjoki Central Hospital, P.O. Box 2000, FI-33521 Tampere, Finland.
Division of Intensive Care, Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University and Helsinki University Hospital, Finland.
Resuscitation. 2017 Mar;112:43-52. doi: 10.1016/j.resuscitation.2016.12.023. Epub 2017 Jan 11.
An abundance of studies have investigated the impact of rapid response teams (RRTs) on in-hospital cardiac arrest rates. However, existing RRT data appear highly variable in terms of both study quality and reported uses of limitations of care, patient survival and patient long-term outcome.
A systematic electronic literature search (January, 1990-March, 2016) of the PubMed and Cochrane databases was performed. Bibliographies of articles included in the full-text review were searched for additional studies. A predefined RRT cohort quality score (range 0-17) was used to evaluate studies independently by two reviewers.
Twenty-nine studies with a total of 157,383 RRT activations were included in this review. The quality of data reporting related to RRT patients was assessed as modest, with a median quality score of 8 (range 2-11). Data from the included studies indicate that a median 8.1% of RRT reviews result in limitations of medical treatment (range 2.1-25%) and 23% (8.2-56%) result in a transfer to intensive care. A median of 29% (6.9-35%) of patients transferred to intensive care died during that admission. The median hospital mortality of patients reviewed by RRT is 26% (12-60%), and the median 30-day mortality rate is 29% (8-39%). Data on long-term survival is minimal. No data on functional outcomes was identified.
Patients reviewed by rapid response teams have a high and variable mortality rate, and limitations of care are commonly used. Data on the long-term outcomes of RRT are lacking and needed.
大量研究探讨了快速反应小组（RRT）对院内心脏骤停发生率的影响。然而，现有的RRT数据在研究质量以及所报告的医疗护理限制的使用、患者生存率和患者长期结局方面似乎差异很大。
对PubMed和Cochrane数据库进行了系统的电子文献检索（1990年1月至2016年3月）。对全文综述中纳入文章的参考文献进行检索以寻找其他研究。使用预先定义的RRT队列质量评分（范围0 - 17）由两名审阅者独立评估研究。
本综述纳入了29项研究，共157,383次RRT激活。与RRT患者相关的数据报告质量评估为中等，质量评分中位数为8（范围2 - 11）。纳入研究的数据表明，RRT评估中医疗治疗受限的中位数为8.1%（范围2.1% - 25%），23%（8.2% - 56%）导致转入重症监护病房。转入重症监护病房的患者在此住院期间死亡的中位数为29%（6.9% - 35%）。RRT评估患者的医院死亡率中位数为26%（12% - 60%），30天死亡率中位数为29%（8% - 39%）。关于长期生存的数据极少。未发现关于功能结局的数据。
由快速反应小组评估的患者死亡率高且差异大，并且医疗护理限制常用。缺乏且需要关于RRT长期结局的数据。
