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Rapid response team activation prior to in-hospital cardiac arrest: Areas for improvements based on a national cohort study

Thorén, Anna (författare)
Department of Medicine Solna, Center for Resuscitation Science, Karolinska Institutet, SE-171 77 Stockholm, Sweden; Department of Clinical Physiology, Danderyd University Hospital, SE-182 88 Stockholm, Sweden
Jonsson, Martin (författare)
Karolinska Institute,Karolinska Institutet,Department of Clinical Science and Education, Södersjukhuset, Center for Resuscitation Science, Karolinska Institutet, SE-118 83 Stockholm, Sweden
Spångfors, Martin (författare)
Lund University,Lunds universitet,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,SWECRIT,Center for cardiac arrest,Lund University Research Groups,Department of Clinical Sciences, Anaesthesiology and Intensive Care, Lund University, SE-221 84 Lund, Sweden; Department of Anaesthesia and Intensive Care, Kristianstad Hospital, SE-291 89 Kristianstad, Sweden.
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Joelsson-Alm, Eva (författare)
Karolinska Institute,Karolinska Institutet,Department of Clinical Science and Education, Södersjukhuset, Center for Resuscitation Science, Karolinska Institutet, SE-118 83 Stockholm, Sweden; Department of Anaesthesia and Intensive Care, Södersjukhuset, SE-118 83 Stockholm, Sweden.
Jakobsson, Jan (författare)
Karolinska Institute,Karolinska Institutet,Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, SE-182 88 Stockholm, Sweden; Department of Anaesthesia and Intensive Care, Danderyd University Hospital, SE-182 88 Stockholm, Sweden.
Rawshani, Araz, 1986 (författare)
Gothenburg University,Göteborgs universitet,University of Gothenburg,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,Department of Molecular and Clinical Medicine, Institute of Medicine, Wallenberg Laboratory, University of Gothenburg, SE-413 45 Gothenburg, Sweden; Department of Cardiology, Sahlgrenska University Hospital/Mölndal, SE-413 45 Gothenburg, Sweden.
Kahan, Thomas (författare)
Karolinska Institutet,Division of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, SE-182 88 Stockholm, Sweden; Department of Cardiology, Danderyd University Hospital, SE-182 88 Stockholm, Sweden.
Engdahl, Johan (författare)
Division of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, SE-182 88 Stockholm, Sweden; Department of Cardiology, Danderyd University Hospital, SE-182 88 Stockholm, Sweden.
Jadenius, Arvid, 1997 (författare)
Gothenburg University,Göteborgs universitet,University of Gothenburg,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,Department of Molecular and Clinical Medicine, Institute of Medicine, Wallenberg Laboratory, University of Gothenburg, SE-413 45 Gothenburg, Sweden.
Boberg von Platen, Erik (författare)
Department of Clinical Science and Education, Södersjukhuset, Center for Resuscitation Science, Karolinska Institutet, SE-118 83 Stockholm, Sweden; Department of Anaesthesia and Intensive Care, Danderyd University Hospital, SE-182 88 Stockholm, Sweden.
Herlitz, Johan, 1949- (författare)
University of Borås,Högskolan i Borås,Akademin för vård, arbetsliv och välfärd,PreHospen
Djärv, Therese (författare)
Karolinska Institutet,Department of Medicine Solna, Center for Resuscitation Science, Karolinska Institutet, SE-171 77 Stockholm, Sweden; Department of Acute and Reparative Medicine, Karolinska University Hospital, SE-171 64, Stockholm, Sweden.
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 (creator_code:org_t)
2023
2023
Engelska.
Ingår i: Resuscitation. - 0300-9572 .- 1873-1570. ; 193
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https://doi.org/10.1...
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http://dx.doi.org/10... (free)
https://urn.kb.se/re...
https://doi.org/10.1...
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • Introduction: Rapid response teams (RRTs) are designed to improve the "chain of prevention" of in-hospital cardiac arrest (IHCA). We studied the 30-day survival of patients reviewed by RRTs within 24 hours prior to IHCA, as compared to patients not reviewed by RRTs.Methods: A nationwide cohort study based on the Swedish Registry of Cardiopulmonary Resuscitation, between January 1st, 2014, and December 31st, 2021. An explorative, hypothesis-generating additional in-depth data collection from medical records was performed in a small subgroup of general ward patients reviewed by RRTs.Results: In all, 12,915 IHCA patients were included. RRT-reviewed patients (n = 2,058) had a lower unadjusted 30-day survival (25% vs 33%, p < 0.001), a propensity score based Odds ratio for 30-day survival of 0.92 (95% Confidence interval 0.90-0.94, p < 0.001) and were more likely to have a respiratory cause of IHCA (22% vs 15%, p < 0.001). In the subgroup (n = 82), respiratory distress was the most common RRT trigger, and 24% of the RRT reviews were delayed. Patient transfer to a higher level of care was associated with a higher 30-day survival rate (20% vs 2%, p < 0.001).Conclusion: IHCA preceded by RRT review is associated with a lower 30-day survival rate and a greater likelihood of a respiratory cause of cardiac arrest. In the small explorative subgroup, respiratory distress was the most common RRT trigger and delayed RRT activation was frequent. Early detection of respiratory abnormalities and timely interventions may have a potential to improve outcomes in RRT-reviewed patients and prevent further progress into IHCA.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Nyckelord

In-hospital cardiac arrest
Medical Emergency Team
National Early Warning Score
Rapid response system
Rapid response team
Människan i vården
The Human Perspective in Care
In-hospital cardiac arrest
Medical Emergency Team
National Early Warning Score
Rapid response system
Rapid response team

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