Delayed Medical Emergency Team Calls and Associated Outcomes
Delayed Medical Emergency Team Calls and Associated Outcomes
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DOI：
10.1097/ccm.0b013e31829e53b9
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发表时间：
2014-01-01
影响因子：
8.8
通讯作者：
Rodrigues Filho, Edison M.
中科院分区：
文献类型：
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作者：
Boniatti, Marcio M.;Azzolini, Neusa;Rodrigues Filho, Edison M.
目的：为了确定延迟的医疗急救小组呼叫和医疗急救小组审查后的死亡率之间是否存在关联。设计：这是一项前瞻性观察研究。设置：巴西波尔图阿莱格雷的一所大学附属三级转诊医院。患者：所有患者均由医疗急救小组从2008年7月至2009年12月进行审查。干预措施：无。测量和主要结果：有1，148名患者拨打了1，481个电话。246例患者（21.4%）发生了延迟的医疗急救小组呼叫。与延迟相关的标准通常与随后的医疗急救小组呼叫的标准相同。医生延迟医疗急救小组呼叫（110/246 [44.7%]）的发生率高于及时医疗急救小组呼叫（267/902 [29.6%]; p < 0.001）。延迟启动医疗急救队的患者在医疗急救队复查后30天的死亡率（152例[61.8%]）高于及时启动医疗急救队的患者（378例[41.9%]; p < 0.001）。在多变量分析中，延迟医疗急救队电话仍然显着相关较高mortality.Conclusions：延迟医疗急救队电话是常见的，是独立的死亡率较高。这一结果再次肯定了快速反应系统的概念和必要性。
Objective: To determine whether there was an association between delayed medical emergency team calls and mortality after a medical emergency team review.Design: This was a prospective observational study.Setting: A university-affiliated tertiary referral hospital in Porto Alegre, Brazil.Patients: All patients were reviewed by the medical emergency team from July 2008 to December 2009.Interventions: None.Measurements and Main Results: There were 1,481 calls for 1,148 patients. Delayed medical emergency team calls occurred for 246 patients (21.4%). The criterion associated with delay was typically the same criterion for the subsequent medical emergency team call. Physicians had a greater prevalence of delayed medical emergency team calls (110 of 246 [44.7%]) than timely medical emergency team calls (267 of 902 [29.6%]; p < 0.001). The mortality at 30 days after medical emergency team review was higher among patients with delayed medical emergency team activation (152 [61.8%]) than patients receiving timely medical emergency team activation (378 [41.9%]; p < 0.001). In a multivariate analysis, delayed medical emergency team calls remained significantly associated with higher mortality.Conclusions: Delayed medical emergency team calls are common and are independently associated with higher mortality. This result reaffirms the concept and need for a rapid response system.