Barbosa Vera, Gomes Ernestina, Vaz Senio, Azevedo Gustavo, Fernandes Gonçalo, Ferreira Amélia, Araujo Rui
Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, EPE - Senhora da Hora, Portugal.
Rev Bras Ter Intensiva. 2016 Oct-Dec;28(4):420-426. doi: 10.5935/0103-507X.20160075.
: To determine the incidence of afferent limb failure of the in-hospital Medical Emergency Team, characterizing it and comparing the mortality between the population experiencing afferent limb failure and the population not experiencing afferent limb failure.
: A total of 478 activations of the Medical Emergency Team of Hospital Pedro Hispano occurred from January 2013 to July 2015. A sample of 285 activations was obtained after excluding incomplete records and activations for patients with less than 6 hours of hospitalization. The sample was divided into two groups: the group experiencing afferent limb failure and the group not experiencing afferent limb failure of the Medical Emergency Team. Both populations were characterized and compared. Statistical significance was set at p ≤ 0.05.
: Afferent limb failure was observed in 22.1% of activations. The causal analysis revealed significant differences in Medical Emergency Team activation criteria (p = 0.003) in the group experiencing afferent limb failure, with higher rates of Medical Emergency Team activation for cardiac arrest and cardiovascular dysfunction. Regarding patient outcomes, the group experiencing afferent limb failure had higher immediate mortality rates and higher mortality rates at hospital discharge, with no significant differences. No significant differences were found for the other parameters.
: The incidence of cardiac arrest and the mortality rate were higher in patients experiencing failure of the afferent limb of the Medical Emergency Team. This study highlights the need for health units to invest in the training of all healthcare professionals regarding the Medical Emergency Team activation criteria and emergency medical response system operations.
确定医院内医疗急救团队传入肢体失败的发生率，对其进行特征描述，并比较发生传入肢体失败人群与未发生传入肢体失败人群的死亡率。
2013年1月至2015年7月期间，佩德罗·伊斯帕诺医院医疗急救团队共激活478次。排除不完整记录以及住院时间少于6小时患者的激活记录后，获得285次激活记录的样本。该样本分为两组：医疗急救团队传入肢体失败组和医疗急救团队未发生传入肢体失败组。对两组人群进行特征描述并比较。设定统计学显著性水平为p≤0.05。
在22.1%的激活记录中观察到传入肢体失败。因果分析显示，传入肢体失败组在医疗急救团队激活标准方面存在显著差异（p = 0.003），心脏骤停和心血管功能障碍的医疗急救团队激活率更高。关于患者结局，传入肢体失败组的即时死亡率和出院时死亡率更高，但无显著差异。其他参数未发现显著差异。
医疗急救团队传入肢体失败患者的心脏骤停发生率和死亡率更高。本研究强调卫生单位需要对所有医护人员进行关于医疗急救团队激活标准和紧急医疗响应系统操作的培训。
