Song In-Ae, Oh Tak Kyu
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, South Korea.
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, South Korea.
J Clin Anesth. 2025 Mar;102:111749. doi: 10.1016/j.jclinane.2025.111749. Epub 2025 Jan 15.
In this population-based cohort study involving a nationwide database from South Korea, we aimed to determine whether rapid response system (RRS) implementation is associated with mortality and morbidity after surgery under general anesthesia.
Patients who underwent surgery under general anesthesia at the hospital between January 1, 2021, and December 31, 2021. Patients admitted to hospitals with an RRS were categorized into the RRS group, whereas those without an RRS were categorized into the non-RRS group. The endpoints were 30-day mortality, 90-day mortality, and CPR performance in the event of cardiac arrest.
A total of 1,416,844 patients who underwent surgery under general anesthesia were included. The RRS and non-RRS groups included 512,911 and 903,933 patients, respectively. After propensity score (PS) matching, 447,998 patients were included in both groups (223,999 patients per group). In the PS-matched cohort, compared with the non-RRS group, the RRS group had 7 % (odds ratio [OR]: 0.93, 95 % confidence interval [CI]: 0.89, 0.97; P = 0.001), 6 % (OR: 0.94, 95 % CI: 0.91, 0.97; P < 0.001), and 9 % (OR: 0.91, 95 % CI: 0.83, 0.98; P = 0.020) lower incidences of 30-day mortality, 90-day mortality, and CPR, respectively.
The RRS group had lower 30-day and 90-day mortality rates than the non-RRS group after surgery under general anesthesia. Moreover, RRS was associated with a lower rate of CPR episodes resulting from cardiac arrest in patients undergoing general anesthesia after surgery.
在这项基于韩国全国性数据库的人群队列研究中，我们旨在确定快速反应系统（RRS）的实施是否与全身麻醉手术后的死亡率和发病率相关。
纳入2021年1月1日至2021年12月31日期间在医院接受全身麻醉手术的患者。入住设有RRS医院的患者被归类为RRS组，而未设有RRS的患者被归类为非RRS组。终点指标为30天死亡率、90天死亡率以及心脏骤停时的心肺复苏（CPR）情况。
总共纳入了1416844例接受全身麻醉手术的患者。RRS组和非RRS组分别包括512911例和903933例患者。在倾向评分（PS）匹配后，两组各纳入447998例患者（每组223999例）。在PS匹配队列中，与非RRS组相比，RRS组的30天死亡率、90天死亡率和CPR发生率分别降低了7%（优势比[OR]：0.93，95%置信区间[CI]：0.89，0.97；P = 0.001）、6%（OR：0.94，95% CI：0.91，0.97；P < 0.001）和9%（OR：0.91，95% CI：0.83，0.98；P = 0.020）。
全身麻醉手术后，RRS组的30天和90天死亡率低于非RRS组。此外，RRS与手术后接受全身麻醉患者因心脏骤停导致的CPR发生率较低相关。
