Department of Anesthesiology and Intensive Care Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Department of Anesthesiology, Okazaki City Hospital, Okazaki, Japan.
J Palliat Med. 2024 Feb;27(2):241-245. doi: 10.1089/jpm.2023.0377. Epub 2023 Oct 18.
We investigated the role of rapid response systems (RRSs) in limitations of medical treatment (LOMT) planning among children, their families, and health care providers. This multicenter retrospective cohort study examined children with clinical deterioration using the Japanese RRS registry between 2012 and 2021. Children ( = 348) at 28 hospitals in Japan who required RRS calls were analyzed. Eleven (3%) of the 348 patients had LOMT before RRS calls and 11 (3%) had newly implemented LOMT after RRS calls. Patients with LOMT were significantly less likely to be admitted to an intensive care unit compared with those without (36% vs. 61%, < 0.001) and were more likely to die within 30 days (45% vs. 11%, < 0.001). LOMT issues existed in 6% of children who received RRS calls. RRS calls for clinically deteriorating children with LOMT were associated with less intensive care and higher mortality.
我们研究了快速反应系统（RRS）在儿童、其家庭和医疗保健提供者的治疗限制（LOMT）规划中的作用。这项多中心回顾性队列研究使用日本 RRS 登记处调查了 2012 年至 2021 年间临床恶化的儿童。分析了日本 28 家医院需要 RRS 呼叫的 348 名儿童。在 RRS 呼叫之前，有 11 名（3%）患者存在 LOMT，在 RRS 呼叫之后，有 11 名（3%）患者新实施了 LOMT。与无 LOMT 患者相比，有 LOMT 患者入住重症监护病房的可能性显著降低（36%对 61%，<0.001），30 天内死亡的可能性也更高（45%对 11%，<0.001）。接受 RRS 呼叫的儿童中存在 6%的 LOMT 问题。对于存在 LOMT 的临床恶化儿童，RRS 呼叫与较低的重症监护和更高的死亡率相关。
