Does the Time of Solitary Rapid Response Team Call Affect Patient Outcome?

OBJECTIVE

The study aimed to evaluate the effect of a single after-hours rapid response team (RRT) calls on patient outcome.

DESIGN

A retrospective cohort study of RRT-call data over a 3-year period.

SETTING

A 600-bedded, tertiary referral, public university hospital.

PARTICIPANTS

All adult patients who had a single RRT-call during their hospital stay.

INTERVENTION

None.

MAIN OUTCOMES MEASURES

The primary outcome was to compare all-cause in-hospital mortality. The secondary outcomes were to study the hourly variation of RRT-calls and the mortality rate.

RESULTS

Of the total 5,108 RRT-calls recorded, 1,916 patients had a single RRT-call. Eight hundred and sixty-one RRT-calls occurred during work-hours (08:00-17:59 hours) and 1,055 during after-hours (18:00-7:59). The all-cause in-hospital mortality was higher (15.07% vs 9.75%, OR 1.64, 95% CI 1.24-2.17, value 0.001) in patients who had an after-hours RRT-call. This difference remained statistically significant after multivariate regression analysis (OR 1.50, 95% CI 1.11-2.01, value 0.001). We noted a lower frequency of hourly RRT-calls after-hours but were associated with higher hourly mortality rates. There was no difference in outcomes for patients who were admitted to ICU post-RRT-call.

CONCLUSION

Patients having an after-hour RRT-call appear to have a higher risk for hospital mortality. No causal mechanism could be identified other than a decrease in hourly RRT usage during after-hours.

HOW TO CITE THIS ARTICLE

Singh MY, Vegunta R, Karpe K, Rai S. Does the Time of Solitary Rapid Response Team Call Affect Patient Outcome? Indian J Crit Care Med 2020;24(1):38-43.