Effectiveness of rapid response teams in reducing intrahospital cardiac arrests and deaths: a systematic review and meta-analysis

Abstract

ObjectiveTo evaluate the effectiveness of rapid response teams using early identification of clinical deterioration in reducing the occurrence of in-hospital mortality and cardiorespiratory arrest.Data sourcesThe MEDLINE, LILACS, Cochrane Library, Center for Reviews and Dissemination databases were searched.Study selectionWe included studies that evaluated the effectiveness of rapid response teams in adult hospital units, published in English, Portuguese, or Spanish, from 2000 to 2016; systematic reviews, clinical trials, cohort studies, and prepost ecological studies were eligible for inclusion. The quality of studies was independently assessed by two researchers using the Newcastle-Ottawa, modified Jadad, and Assessment of Multiple Systematic Reviews scales.Data extractionsThe results were synthesized and tabulated. When risk measures were reported by the authors of the included studies, we estimated effectiveness as 1-RR or 1-OR. In pre-post studies, we estimated effectiveness as the percent decrease in rates following the intervention.ResultsOverall, 278 studies were identified, 256 of which were excluded after abstract evaluation, and two of which were excluded after full text evaluation. In the meta-analysis of the studies reporting mortality data, we calculated a risk ratio of 0.85 (95%CI 0.76 - 0.94); and for studies reporting cardiac arrest data the estimated risk ratio was 0.65 (95%CI 0.49 - 0.87). Evidence was assessed as low quality due to the high heterogeneity and risk of bias in primary studies.ConclusionWe conclude that rapid response teams may reduce in-hospital mortality and cardiac arrests, although the quality of evidence for both outcomes is low.

Barriers and enablers of recognition and response to deteriorating patients in the acute hospital setting: A theory‐driven interview study using the Theoretical Domains Framework

“…Review findings suggest that escalation to a designated response team is associated with reduced in‐hospital cardiac arrest and mortality (Maharaj et al, 2015; Rocha et al, 2018). However, patients will only benefit from the additional expertise provided by these teams if they are activated and mobilised to the patient's location (Lyons et al, 2018).…”

Do Physiological Variables Predict the Need for Transport to Hospital From Music Festivals? An Analysis of Australian Festival Data

“…21 Implementation of MET systems have been associated with reductions in cardiac arrest in low quality trials, but have not been shown to definitively improve patient outcome in randomized controlled trials, and do increase healthcare use and, hence, cost. 8,11,22 On the basis of these data, it is likely that mandating the transport to hospital of will increase use of ambulance resources and increase costs without improving patient outcome.…”

“…These commonly take the form of Medical Emergency Team (MET) calling criteria. 8 An example system is the NSW Health "Between the flags" system, 9 presented in Table 1. The utility of these criteria in identifying patients requiring transport to hospital from a music festival has not been previously examined.…”

Atendimento inicial na parada cardiorrespiratória: uma revisão integrativa da literatura

“…Ainda no âmbito de obtenção de conhecimento, os autores Carbogim et al (2020) evidenciaram quão necessário se faz abordar nos cursos de primeiros socorros para estudantes de graduação de enfermagem, além das condutas e técnicas presentes na RCP, o modelo de ensino ativo para o pensamento crítico. Já Rocha et al (2018) concluíram que as equipes de resposta rápida reduzem a mortalidade e a recorrência de parada cardiorrespiratória, no entanto com baixa qualidade e evidência.…”