Author/Authors :
Lee, Hong Yeul Department of Internal Medicine - Seoul National University Hospital - Seoul, Korea , Lee, Jinwoo Department of Internal Medicine - Seoul National University Hospital - Seoul, Korea , Lee, Sang-Min Department of Internal Medicine - Seoul National University Hospital - Seoul, Korea , Kim, Sulhee Department of Internal Medicine Rapid Response Team - Seoul National University Hospital - Seoul, Korea , Yang, Eunjin Department of Internal Medicine Rapid Response Team - Seoul National University Hospital - Seoul, Korea , Lee, Hyun Joo Departments of Thoracic and Cardiovascular Surgery - Seoul National University Hospital - Seoul National University College of Medicine - Seoul, Korea , Lee, Hannah Departments of Anesthesiology and Pain Medicine - Seoul National University Hospital - Seoul National University College of Medicine - Seoul, Korea , Ryu, Ho Geol Departments of Anesthesiology and Pain Medicine - Seoul National University Hospital - Seoul National University College of Medicine - Seoul, Korea , Oh, Seung-Young Department of General Surgery - Critical Care Center - Seoul National University Hospital - Seoul, Korea , Ha, Eun Jin Department of General Surgery - Critical Care Center - Seoul National University Hospital - Seoul, Korea , Ko, Sang-Bae Department of Neurology - Seoul National University Hospital - Seoul, Korea , Cho, Jaeyoung Department of Internal Medicine - Seoul National University Hospital - Seoul, Korea
Abstract :
Background: To determine the effects of implementing a rapid response system (RRS) on
code rates and in-hospital mortality in medical wards.
Methods: This retrospective study included adult patients admitted to medical wards at Seoul
National University Hospital between July 12, 2016 and March 12, 2018; the sample comprised
4,224 patients admitted 10 months before RRS implementation and 4,168 patients admitted
10 months following RRS implementation. Our RRS only worked during the daytime (7 AM
to 7 PM) on weekdays. We compared code rates and in-hospital mortality rates between the
preintervention and postintervention groups.
Results: There were 62.3 RRS activations per 1,000 admissions. The most common reasons for
RRS activation were tachypnea or hypopnea (44%), hypoxia (31%), and tachycardia or bradycardia (21%). Code rates from medical wards during RRS operating times significantly decreased from 3.55 to 0.96 per 1,000 admissions (adjusted odds ratio [aOR], 0.29; 95% confidence
interval [CI], 0.10 to 0.87; P=0.028) after RRS implementation. However, code rates from medical wards during RRS nonoperating times did not differ between the preintervention and
postintervention groups (2.60 vs. 3.12 per 1,000 admissions; aOR, 1.23; 95% CI, 0.55 to 2.76;
P=0.614). In-hospital mortality significantly decreased from 56.3 to 42.7 per 1,000 admissions after RRS implementation (aOR, 0.79; 95% CI, 0.64 to 0.97; P=0.024).
Conclusions: Implementation of an RRS was associated with significant reductions in code
rates during RRS operating times and in-hospital mortality in medical wards.
Keywords :
cardiopulmonary resuscitation , hospital mortality , hospital rapid response team , internal medicine
