Choi Hey-Ran, Song In-Ae, Oh Tak Kyu
Department of Anesthesiology and Pain Medicine, Inje University Sanggye Paik Hospital, Seoul, South Korea.
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 173, Beon-gil, Bundang-gu, Seongnam, South Korea.
Perioper Med (Lond). 2024 Oct 4;13(1):98. doi: 10.1186/s13741-024-00458-9.
Rapid response systems (RRSs) are used in hospitals to identify and treat deteriorating patients. However, RRS implementation and outcomes in orthopedic and surgical patients remain controversial. We aimed to investigate whether the RRS affects mortality and complications after orthopedic surgery.
The National Health Insurance Service of South Korea provided the data for this population-based cohort study. Individuals who were admitted to the hospital that implemented RRS were categorized into the RRS group and those admitted to a hospital that did not implement the RRS were categorized into the non-RRS group. In-hospital mortality and postoperative complications were the endpoints.
A total of 931,774 adult patients were included. Among them, 93,293 patients underwent orthopedic surgery in a hospital that implemented RRS and were assigned to the RRS group, whereas 838,481 patients were assigned to the non-RRS group. In multivariable logistic regression analysis, the RRS group was not associated with in-hospital mortality after orthopedic surgery compared with the non-RRS group (odds ratio [OR] 0.93, 95% confidence interval [CI] 0.80, 1.08; P = 0.350). However, the RRS group was associated with a 14% lower postoperative complication rate after orthopedic surgery than the non-RRS group (OR 0.86, 95% CI 0.84, 0.86; P < 0.001).
The RRS was not associated with in-hospital mortality following orthopedic surgery in South Korea. However, RRS deployment was related to a decreased risk of postoperative complications in patients undergoing orthopedic surgery.
医院使用快速反应系统（RRS）来识别和治疗病情恶化的患者。然而，RRS在骨科和外科患者中的实施情况及结果仍存在争议。我们旨在调查RRS是否会影响骨科手术后的死亡率和并发症。
韩国国家健康保险服务机构为本基于人群的队列研究提供了数据。入住实施RRS医院的个体被归类为RRS组，入住未实施RRS医院的个体被归类为非RRS组。住院死亡率和术后并发症为研究终点。
共纳入931,774例成年患者。其中，93,293例患者在实施RRS的医院接受了骨科手术并被分配到RRS组，而838,481例患者被分配到非RRS组。在多变量逻辑回归分析中，与非RRS组相比，RRS组在骨科手术后与住院死亡率无关（比值比[OR]为0.93，95%置信区间[CI]为0.80, 1.08；P = 0.350）。然而，RRS组骨科手术后的术后并发症发生率比非RRS组低14%（OR为0.86，95% CI为0.84, 0.86；P < 0.001）。
在韩国，RRS与骨科手术后的住院死亡率无关。然而，RRS的部署与接受骨科手术患者术后并发症风险的降低有关。
