Park Yeonhee, Ahn Jong-Joon, Kang Byung Ju, Lee Young Seok, Ha Sang-Ook, Min Jin-Soo, Cho Woo-Hyun, Na Se-Hee, Lee Dong-Hyun, Park Seung-Yong, Hong Goo-Hyeon, Kim Hyun-Jung, Shim Sangwoo, Kim Jung-Hyun, Lee Seok-Jeong, Park So-Young, Moon Jae Young
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Korean J Crit Care Med. 2017 Aug;32(3):231-239. doi: 10.4266/kjccm.2017.00024. Epub 2017 Aug 31.
Early recognition of the signs and symptoms of clinical deterioration could diminish the incidence of cardiopulmonary arrest. The present study investigates outcomes with respect to cardiopulmonary arrest rates in institutions with and without rapid response systems (RRSs) and the current level of cardiopulmonary arrest rate in tertiary hospitals.
This was a retrospective study based on data from 14 tertiary hospitals. Cardiopulmonary resuscitation (CPR) rate reports were obtained from each hospital to include the number of cardiopulmonary arrest events in adult patients in the general ward, the annual adult admission statistics, and the structure of the RRS if present.
Hospitals with RRSs showed a statistically significant reduction of the CPR rate between 2013 and 2015 (odds ratio [OR], 0.731; 95% confidence interval [CI], 0.577 to 0.927; P = 0.009). Nevertheless, CPR rates of 2013 and 2015 did not change in hospitals without RRS (OR, 0.988; 95% CI, 0.868 to 1.124; P = 0.854). National university-affiliated hospitals showed less cardiopulmonary arrest rate than private university-affiliated in 2015 (1.92 vs. 2.40; OR, 0.800; 95% CI, 0.702 to 0.912; P = 0.001). High-volume hospitals showed lower cardiopulmonary arrest rates compared with medium-volume hospitals in 2013 (1.76 vs. 2.63; OR, 0.667; 95% CI, 0.577 to 0.772; P < 0.001) and in 2015 (1.55 vs. 3.20; OR, 0.485; 95% CI, 0.428 to 0.550; P < 0.001).
RRSs may be a feasible option to reduce the CPR rate. The discrepancy in cardiopulmonary arrest rates suggests further research should include a nationwide survey to tease out factors involved in in-hospital cardiopulmonary arrest and differences in outcomes based on hospital characteristics.
早期识别临床病情恶化的体征和症状可降低心肺骤停的发生率。本研究调查了设有和未设有快速反应系统（RRS）的机构中心肺骤停率的相关结果，以及三级医院目前的心肺骤停率水平。
这是一项基于14家三级医院数据的回顾性研究。从每家医院获取心肺复苏（CPR）率报告，包括普通病房成年患者的心肺骤停事件数量、年度成年患者入院统计数据，以及（若设有）快速反应系统的结构。
设有快速反应系统的医院在2013年至2015年间心肺复苏率有统计学意义的降低（优势比[OR]，0.731；95%置信区间[CI]，0.577至0.927；P = 0.009）。然而，未设有快速反应系统的医院在2013年和2015年的心肺复苏率没有变化（OR，0.988；95% CI，0.868至1.124；P = 0.854）。2015年，国立大学附属医院的心肺骤停率低于私立大学附属医院（1.92对2.40；OR，0.800；95% CI，0.702至0.912；P = 0.001）。2013年（1.
