与快速反应团队激活延迟相关的因素。
Factors associated with delayed rapid response team activation.
机构信息
Division of Critical Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada; Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada.
Division of Critical Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada; Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada.
出版信息
J Crit Care. 2018 Aug;46:73-78. doi: 10.1016/j.jcrc.2018.04.010. Epub 2018 Apr 19.
Delayed activation of the rapid response team (RRT) is common and has been associated with adverse outcomes. However, little is known about the factors associated with delayed activation. This was an observational study from two hospitals in Ottawa, Canada, including adult inpatients with experiencing an activation of the RRT. Data was collected between May 1, 2012 and May 31, 2016 and groups were divided between those with activation within 1 h of meeting call criteria and those with >1 h (delayed activation). The primary outcome was in-hospital mortality. There were 6131 patients included in the study, of which 1441 (26.0%) experienced a delay. The reasons for RRT call were significantly different (P < 0.001) with respiratory distress (29.3% versus 24.8%), and hypotension (17.4% versus 13.2%) being more common in the delayed group, and dysrhythmias (15.9% versus 18.5%) and altered level of consciousness (13.5% versus 18.7%) being less common. RRT activation was more delayed on non-surgical services (P < 0.001). Delayed activation was associated with increased mortality (Adjusted odds ratio [OR] 1.23, 95% CI 1.07-1.41), ICU admission (Adjusted OR 1.72, 95% CI 1.51-1.96), and hospital length of stay (13 versus 15 days, P < 0.001).
延迟启动快速反应团队（RRT）很常见，并且与不良结局相关。然而，对于与延迟启动相关的因素知之甚少。这是一项来自加拿大渥太华的两家医院的观察性研究，包括经历 RRT 启动的成年住院患者。数据收集于 2012 年 5 月 1 日至 2016 年 5 月 31 日之间，将在符合 RRT 激活标准后 1 小时内激活的患者分为一组，将延迟激活的患者分为另一组。主要结局是院内死亡率。该研究共纳入 6131 例患者，其中 1441 例（26.0%）出现延迟。RRT 呼叫的原因明显不同（P < 0.001），呼吸窘迫（29.3% 比 24.8%）和低血压（17.4% 比 13.2%）在延迟组中更为常见，而心律失常（15.9% 比 18.5%）和意识水平改变（13.5% 比 18.7%）则更为少见。非手术科室的 RRT 激活延迟更为明显（P < 0.001）。延迟激活与死亡率增加（校正比值比 [OR] 1.23，95%CI 1.07-1.41）、入住 ICU（校正 OR 1.72，95%CI 1.51-1.96）和住院时间延长（13 天比 15 天，P < 0.001）相关。
Zotero 插件