Impact of hospitalization duration before medical emergency team activation: A retrospective cohort study
The rapid response system has been implemented in many hospitals worldwide and, reportedly, the timing of medical emergency team (MET) attendance in relation to the duration of hospitalization is associated with the mortality of MET patients. We evaluated the relationship between duration of hospita...
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| Veröffentlicht in: | PloS one 2021-02, Vol.16 (2), p.e0247066-e0247066 |
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| creator | Lee, Jinmi Shin, Yujung Choi, Eunjoo Choi, Sunhui Son, Jeongsuk Jung, Youn Kyung Hong, Sang-Bum |
| description | The rapid response system has been implemented in many hospitals worldwide and, reportedly, the timing of medical emergency team (MET) attendance in relation to the duration of hospitalization is associated with the mortality of MET patients. We evaluated the relationship between duration of hospitalization before MET activation and patient mortality. We compared cases of MET activation for early, intermediate, and late deterioration to patient characteristics, activation characteristics, and patient outcomes. We also aimed to determine the relationship, after adjusting for confounders, between the duration of hospitalization before MET activation and patient mortality.
We retrospectively evaluated patients who triggered MET activation in general wards from March 2009 to February 2015 at the Asan Medical Center in Seoul. Patients were categorized as those with early deterioration (less than 2 days after admission), intermediate deterioration (2-7 days after admission), and late deterioration (more than 7 days after admission) and compared them to patient characteristics, activation characteristics, and patient outcomes.
Overall, 7114 patients were included. Of these, 1793 (25.2%) showed early deterioration, 2113 (29.7%) showed intermediate deterioration, and 3208 (45.1%) showed late deterioration. Etiologies of MET activation were similar among these groups. The clinical outcomes significantly differed among the groups (intensive care unit transfer: 34.1%, 35.6%, and 40.4%; p < 0.001 and mortality: 26.3%, 31.5%, and 41.2%; p < 0.001 for early, intermediate, and late deterioration, respectively). Compared with early deterioration and adjusted for confounders, the odds ratio of mortality for late deterioration was 1.68 (1.46-1.93).
Nearly 50% of the acute clinically-deteriorating patients who activated the MET had been hospitalized for more than 7 days. Furthermore, they presented with higher rates of mortality and ICU transfer than patients admitted for less than 7 days before MET activation and had mortality as an independent risk factor. |
| doi_str_mv | 10.1371/journal.pone.0247066 |
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We retrospectively evaluated patients who triggered MET activation in general wards from March 2009 to February 2015 at the Asan Medical Center in Seoul. Patients were categorized as those with early deterioration (less than 2 days after admission), intermediate deterioration (2-7 days after admission), and late deterioration (more than 7 days after admission) and compared them to patient characteristics, activation characteristics, and patient outcomes.
Overall, 7114 patients were included. Of these, 1793 (25.2%) showed early deterioration, 2113 (29.7%) showed intermediate deterioration, and 3208 (45.1%) showed late deterioration. Etiologies of MET activation were similar among these groups. The clinical outcomes significantly differed among the groups (intensive care unit transfer: 34.1%, 35.6%, and 40.4%; p < 0.001 and mortality: 26.3%, 31.5%, and 41.2%; p < 0.001 for early, intermediate, and late deterioration, respectively). Compared with early deterioration and adjusted for confounders, the odds ratio of mortality for late deterioration was 1.68 (1.46-1.93).
Nearly 50% of the acute clinically-deteriorating patients who activated the MET had been hospitalized for more than 7 days. Furthermore, they presented with higher rates of mortality and ICU transfer than patients admitted for less than 7 days before MET activation and had mortality as an independent risk factor.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0247066</identifier><identifier>PMID: 33606743</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Biology and Life Sciences ; Cohort analysis ; Critical care ; Electronic health records ; Electronic medical records ; Emergency medical services ; Gastrointestinal cancer ; Health care ; Health care facilities ; Health care teams ; Hemodynamics ; Hospital care ; Hospitalization ; Hospitals ; Intubation ; Laboratory tests ; Lactic acid ; Medical emergencies ; Medical personnel ; Medical records ; Medical research ; Medicine ; Medicine and Health Sciences ; Medicine, Experimental ; Monitoring ; Mortality ; Nurses ; Patients ; People and Places ; Physicians ; Respiratory tract ; Sepsis ; South Korea ; Statistics ; Telemedicine ; Vital signs</subject><ispartof>PloS one, 2021-02, Vol.16 (2), p.e0247066-e0247066</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Lee et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Lee et al 2021 Lee et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-2daa68ebbf21b03540cc00d4deeef45b16b136a779f8991a6f53fceff5b237683</citedby><cites>FETCH-LOGICAL-c692t-2daa68ebbf21b03540cc00d4deeef45b16b136a779f8991a6f53fceff5b237683</cites><orcidid>0000-0003-2737-7695</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7894955/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7894955/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33606743$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Chen, Tai-Heng</contributor><creatorcontrib>Lee, Jinmi</creatorcontrib><creatorcontrib>Shin, Yujung</creatorcontrib><creatorcontrib>Choi, Eunjoo</creatorcontrib><creatorcontrib>Choi, Sunhui</creatorcontrib><creatorcontrib>Son, Jeongsuk</creatorcontrib><creatorcontrib>Jung, Youn Kyung</creatorcontrib><creatorcontrib>Hong, Sang-Bum</creatorcontrib><title>Impact of hospitalization duration before medical emergency team activation: A retrospective cohort study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The rapid response system has been implemented in many hospitals worldwide and, reportedly, the timing of medical emergency team (MET) attendance in relation to the duration of hospitalization is associated with the mortality of MET patients. We evaluated the relationship between duration of hospitalization before MET activation and patient mortality. We compared cases of MET activation for early, intermediate, and late deterioration to patient characteristics, activation characteristics, and patient outcomes. We also aimed to determine the relationship, after adjusting for confounders, between the duration of hospitalization before MET activation and patient mortality.
We retrospectively evaluated patients who triggered MET activation in general wards from March 2009 to February 2015 at the Asan Medical Center in Seoul. Patients were categorized as those with early deterioration (less than 2 days after admission), intermediate deterioration (2-7 days after admission), and late deterioration (more than 7 days after admission) and compared them to patient characteristics, activation characteristics, and patient outcomes.
Overall, 7114 patients were included. Of these, 1793 (25.2%) showed early deterioration, 2113 (29.7%) showed intermediate deterioration, and 3208 (45.1%) showed late deterioration. Etiologies of MET activation were similar among these groups. The clinical outcomes significantly differed among the groups (intensive care unit transfer: 34.1%, 35.6%, and 40.4%; p < 0.001 and mortality: 26.3%, 31.5%, and 41.2%; p < 0.001 for early, intermediate, and late deterioration, respectively). Compared with early deterioration and adjusted for confounders, the odds ratio of mortality for late deterioration was 1.68 (1.46-1.93).
Nearly 50% of the acute clinically-deteriorating patients who activated the MET had been hospitalized for more than 7 days. Furthermore, they presented with higher rates of mortality and ICU transfer than patients admitted for less than 7 days before MET activation and had mortality as an independent risk factor.</description><subject>Biology and Life Sciences</subject><subject>Cohort analysis</subject><subject>Critical care</subject><subject>Electronic health records</subject><subject>Electronic medical records</subject><subject>Emergency medical services</subject><subject>Gastrointestinal cancer</subject><subject>Health care</subject><subject>Health care facilities</subject><subject>Health care teams</subject><subject>Hemodynamics</subject><subject>Hospital care</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Intubation</subject><subject>Laboratory tests</subject><subject>Lactic acid</subject><subject>Medical emergencies</subject><subject>Medical personnel</subject><subject>Medical records</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Medicine, Experimental</subject><subject>Monitoring</subject><subject>Mortality</subject><subject>Nurses</subject><subject>Patients</subject><subject>People and Places</subject><subject>Physicians</subject><subject>Respiratory tract</subject><subject>Sepsis</subject><subject>South Korea</subject><subject>Statistics</subject><subject>Telemedicine</subject><subject>Vital 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of hospitalization duration before medical emergency team activation: A retrospective cohort study</title><author>Lee, Jinmi ; Shin, Yujung ; Choi, Eunjoo ; Choi, Sunhui ; Son, Jeongsuk ; Jung, Youn Kyung ; Hong, Sang-Bum</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-2daa68ebbf21b03540cc00d4deeef45b16b136a779f8991a6f53fceff5b237683</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Biology and Life Sciences</topic><topic>Cohort analysis</topic><topic>Critical care</topic><topic>Electronic health records</topic><topic>Electronic medical records</topic><topic>Emergency medical services</topic><topic>Gastrointestinal cancer</topic><topic>Health care</topic><topic>Health care facilities</topic><topic>Health care teams</topic><topic>Hemodynamics</topic><topic>Hospital care</topic><topic>Hospitalization</topic><topic>Hospitals</topic><topic>Intubation</topic><topic>Laboratory tests</topic><topic>Lactic acid</topic><topic>Medical emergencies</topic><topic>Medical personnel</topic><topic>Medical records</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Medicine, Experimental</topic><topic>Monitoring</topic><topic>Mortality</topic><topic>Nurses</topic><topic>Patients</topic><topic>People and Places</topic><topic>Physicians</topic><topic>Respiratory tract</topic><topic>Sepsis</topic><topic>South Korea</topic><topic>Statistics</topic><topic>Telemedicine</topic><topic>Vital signs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Jinmi</creatorcontrib><creatorcontrib>Shin, Yujung</creatorcontrib><creatorcontrib>Choi, Eunjoo</creatorcontrib><creatorcontrib>Choi, Sunhui</creatorcontrib><creatorcontrib>Son, 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duration before medical emergency team activation: A retrospective cohort study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2021-02-19</date><risdate>2021</risdate><volume>16</volume><issue>2</issue><spage>e0247066</spage><epage>e0247066</epage><pages>e0247066-e0247066</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The rapid response system has been implemented in many hospitals worldwide and, reportedly, the timing of medical emergency team (MET) attendance in relation to the duration of hospitalization is associated with the mortality of MET patients. We evaluated the relationship between duration of hospitalization before MET activation and patient mortality. We compared cases of MET activation for early, intermediate, and late deterioration to patient characteristics, activation characteristics, and patient outcomes. We also aimed to determine the relationship, after adjusting for confounders, between the duration of hospitalization before MET activation and patient mortality.
We retrospectively evaluated patients who triggered MET activation in general wards from March 2009 to February 2015 at the Asan Medical Center in Seoul. Patients were categorized as those with early deterioration (less than 2 days after admission), intermediate deterioration (2-7 days after admission), and late deterioration (more than 7 days after admission) and compared them to patient characteristics, activation characteristics, and patient outcomes.
Overall, 7114 patients were included. Of these, 1793 (25.2%) showed early deterioration, 2113 (29.7%) showed intermediate deterioration, and 3208 (45.1%) showed late deterioration. Etiologies of MET activation were similar among these groups. The clinical outcomes significantly differed among the groups (intensive care unit transfer: 34.1%, 35.6%, and 40.4%; p < 0.001 and mortality: 26.3%, 31.5%, and 41.2%; p < 0.001 for early, intermediate, and late deterioration, respectively). Compared with early deterioration and adjusted for confounders, the odds ratio of mortality for late deterioration was 1.68 (1.46-1.93).
Nearly 50% of the acute clinically-deteriorating patients who activated the MET had been hospitalized for more than 7 days. Furthermore, they presented with higher rates of mortality and ICU transfer than patients admitted for less than 7 days before MET activation and had mortality as an independent risk factor.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>33606743</pmid><doi>10.1371/journal.pone.0247066</doi><tpages>e0247066</tpages><orcidid>https://orcid.org/0000-0003-2737-7695</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Biology and Life Sciences Cohort analysis Critical care Electronic health records Electronic medical records Emergency medical services Gastrointestinal cancer Health care Health care facilities Health care teams Hemodynamics Hospital care Hospitalization Hospitals Intubation Laboratory tests Lactic acid Medical emergencies Medical personnel Medical records Medical research Medicine Medicine and Health Sciences Medicine, Experimental Monitoring Mortality Nurses Patients People and Places Physicians Respiratory tract Sepsis South Korea Statistics Telemedicine Vital signs |
| title | Impact of hospitalization duration before medical emergency team activation: A retrospective cohort study |
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