Characteristics and outcomes of patients screened by rapid response team who transferred to the intensive care unit

Abstract

Background The utilization of a rapid response team (RRT) has influenced the clinical outcomes of patients in the general ward. However, the characteristics of RRT-screened patients who are transferred to the intensive care unit (ICU) are unknown. Therefore, the present study aimed to evaluate these factors. Methods We conducted a retrospective study using patient data from a tertiary medical center in Republic of Korea between January 2016 and December 2017. Multivariate logistic regression analyses were performed to assess the factors associated with the risk of in-hospital mortality. Results A total of 1,096 patients were included: 389 patients were transferred to the ICU, and 707 patients stayed in the ward. Patients in the ICU group were more likely to be admitted for medical reasons, hepatobiliary disease, and high heart rate. More interventions were performed, hospital stays were longer, and the 28-day and in-hospital mortality rates were higher in the ICU group than in the ward group. Multivariate logistic regression analyses showed that risk factors affecting ICU admission were higher Sequential Organ Failure Assessment (SOFA) score, National Early Warning Score (NEWS), platelet count, and lactate level. ICU transfer was not associated with in-hospital mortality. Conclusions Among RRT-screened patients, those with higher SOFA score, NEWS, and lactate level were more likely to be transferred to the ICU. Therefore, these patients should be closely monitored and considered for ICU transfer.

Impact of ICU Admission Thresholds on Outcomes in Rapid Response System Activations: A Multicenter Study in Japan

“…We found that ICU admission rates in this study were notably more varied compared to previous research [12,[16][17][18][19][20]. Jones et al documented that ICU admission rates through RRS activations uctuated between 10-25% [16],, yet other observational studies have observed even broader ranges, reaching up to 57% [12,[17][18][19][20][21].…”

“…When the Rapid Response System (RRS) is triggered for a ward patient, the RRS team must decide whether to escalate care to the ICU or continue management on the ward. While various exploratory studies have identi ed factors in uencing ICU admissions post-RRS activation [12][13][14], the external validity of these indicators remains unveri ed, and no standardized criteria for ICU admission have been universally adopted. Jones et al reported that decisions for ICU admission were in uenced by the sta ng levels and experience on the ward, the availability of ICU beds, and the feasibility of administering speci c treatments in both the ward and high-dependency settings [15].…”

“…They also highlighted that individual hospitals frequently established their own detailed criteria for ICU admissions, with ratios ranging from 10 to 25% of all RRS activations [16]. Nonetheless, the actual variability in ICU admission ratios across different institutions can be broader [12,[17][18][19][20][21]. Prior studies have not conclusively determined whether this variability in ICU admission rates is attributed to differences in admission thresholds or to variations in patient severity [12][13][14][17][18][19][20].…”

“…Nonetheless, the actual variability in ICU admission ratios across different institutions can be broader [12,[17][18][19][20][21]. Prior studies have not conclusively determined whether this variability in ICU admission rates is attributed to differences in admission thresholds or to variations in patient severity [12][13][14][17][18][19][20].…”

Characteristics and Outcomes of Patients Screened by the Rapid Response Team and Transferred to Intensive Care Unit in South Korea

“….40] vs. 9.60 [6.40-14.0] 10 3 /µL, P < 0.001), and lactate level (2.40 [1.40-4.50] vs. 1.70 [1.16-2.88] mEq/L, P < 0.001) were higher in the ICU group than in the GW group. In addition, patients admitted to the ICU had a longer hospitalization time prior to RRT activation than those who were not (6 [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] vs. 4 [1][2] days; P < 0.001). There were no signi cant between-group differences in terms of other characteristics (…”