Abstract
Aim
Study the incidence and reasons behind in-hospital cardiac arrests (IHCAs) after rapid
response team (RRT) reviews.
Methods
We conducted a matched case–control study at Tampere University Hospital, Finland.
Data on adult patients who were triaged to remain on general ward after first (index)
RRT review without treatment limitations but who suffered an IHCA within the following
48 h were prospectively collected for 5.3 years. These cases were matched (age ±3
years, sex, surgical/medical ward, admission year) at a 1:4 ratio to controls (no
ICHA after RRT review).
Results
Of 2653 index RRT reviews, 17 patients suffered an IHCA on general ward within the
48 h after review. Their 30-day mortality rate was 88%. The incidence was 6.3/1000
index RRT reviews or 4.6/100,000 hospital admissions. Patients who suffered an IHCA
within 48 h after RRT review were more likely to have a preceding ICU admission, and
their median national early warning scores (NEWSs) at the end of the index RRT reviews
(=last NEWSs) were higher than those of the controls. Higher last NEWS was the only
factor associated with ICHA after RRT review (OR 1.22, 95% CI 1.00–1.49, p = 0.048) in a conditional multivariable regression model.
Conclusions
IHCA within 48 h after an index RRT review on general ward is a rare event with poor
prognosis. It is independently associated with higher NEWS at the end of the index
RRT review. Careful consideration is stressed, when patients with high NEWS are left
on ward after RRT reviews.
Keywords
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Article info
Publication history
Published online: March 06, 2018
Accepted:
March 5,
2018
Received in revised form:
February 4,
2018
Received:
October 10,
2017
Footnotes
☆A Spanish translated version of the abstract of this article appears as Appendix in the final online version at https://doi.org/10.1016/j.resuscitation.2018.03.007.
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
