Acute and Critical Care

Mi Ra Han

2 Articles

Rapid response system
Utilization of a rapid response team and associated outcomes in patients with malignancy: Jongmin Lee, Woo Ho Ban, Sei Won Kim, Eun Young Kim, Mi Ra Han, Seok Chan Kim; Acute Crit Care. 2020;35(1):16-23. Published online February 29, 2020; DOI: https://doi.org/10.4266/acc.2019.00675

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Background
Recent advances in diagnosis and treatment have improved long-term outcomes in cancer patients. As a result, the requirement for a rapid response team (RRT) for cancer patients is also increasing. This study aimed to analyze utilization of an RRT and the associations between related factors and mortality in a population of cancer patients. Methods: This retrospective cohort study included hospitalized patients at a single academic medical center in Seoul, Korea, who required RRT activation during a 6-year period from June 2013 to December 2018. Results: Overall, 164 of the 457 patients who met the above criteria were cancer patients, and they had a significantly higher Charlson comorbidity score than the non-cancer patients (5.0 vs. 7.0, P<0.001). A significantly larger proportion of cancer patients required intensive care unit transfer (51.8% vs. 41.0%, P=0.032). Cancer patients also had significantly higher in-hospital mortality compared with other patients (39.6% vs. 10.9%, P<0.001). Furthermore, presence of cancer was independently associated with in-hospital mortality (adjusted odds ratio [OR], 2.09; 95% confidence interval [CI], 1.11 to 3.93). Among cancer patients, higher Acute Physiology and Chronic Health Evaluation (APACHE) II at the time of RRT activation was significantly associated with in-hospital mortality regardless of malignancy (adjusted OR, 1.08; 95% CI, 1.01 to 1.15). Conclusions: Cancer patients requiring RRT activation have significantly higher rates of inhospital mortality than patients not using RRT. Higher severity score at the time of RRT activation in patients with malignancy was significantly associated with in-hospital mortality.

Citations

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Intensivmedizinisches Kontinuum in der Versorgung von Krebskranken
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InFo Hämatologie + Onkologie.2023; 26(5): 10. CrossRef
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Song-I. Lee, Jeong Suk Koh, Yoon Joo Kim, Da Hyun Kang, Jeong Eun Lee
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Journal of Korean Medical Science.2021;[Epub] CrossRef
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Annals of the Academy of Medicine, Singapore.2021; 50(11): 838. CrossRef
Effectiveness of Rapid Response Team on In-hospital Mortality in Patients with Hematologic Malignancy
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Quality Improvement in Health Care.2021; 27(2): 18. CrossRef

Rapid response system
Epidemiology and Clinical Characteristics of Rapid Response Team Activations: Sei Won Kim, Hwa Young Lee, Mi Ra Han, Yong Suk Lee, Eun Hyoung Kang, Eun Ju Jang, Keum Sook Jeun, Seok Chan Kim; Korean J Crit Care Med. 2017;32(2):124-132. Published online May 31, 2017; DOI: https://doi.org/10.4266/kjccm.2017.00199

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Abstract PDF

Background
To ensure patient safety and improvements in the quality of hospital care, rapid response teams (RRTs) have been implemented in many countries, including Korea. The goal of an RRT is early identification and response to clinical deterioration in patients. However, there are differences in RRT systems among hospitals and limited data are available.
Methods
In Seoul St. Mary’s Hospital, the St. Mary’s Advanced Life Support Team was implemented in June 2013. We retrospectively reviewed the RRT activation records of 287 cases from June 2013 to December 2016.
Results
The median response time and median modified early warning score were 8.6 minutes (interquartile range, 5.6 to 11.6 minutes) and 5.0 points (interquartile range, 4.0 to 7.0 points), respectively. Residents (35.8%) and nurses (59.1%) were the main activators of the RRT. Interestingly, postoperative patients account for a large percentage of the RRT activation cases (69.3%). The survival rate was 83.6% and survival was mainly associated with malignancy, Acute Physiology and Chronic Health Evaluation-II score, and the time from admission to RRT activation. RRT activation with screening showed a better outcome compared to activation via a phone call in terms of the intensive care unit admission rate and length of hospital stay after RRT activation.
Conclusions
Malignancy was the most important factor related to survival. In addition, RRT activation with patient screening showed a better outcome compared to activation via a phone call. Further studies are needed to determine the effective screening criteria and improve the quality of the RRT system.

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Heliyon.2022; 8(2): e08944. CrossRef
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Journal of Patient Safety.2021; 17(8): e1332. CrossRef
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