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Original Article
Rapid response system
Effect of a rapid response system on code rates and in-hospital mortality in medical wards
Hong Yeul Lee, Jinwoo Lee, Sang-Min Lee, Sulhee Kim, Eunjin Yang, Hyun Joo Lee, Hannah Lee, Ho Geol Ryu, Seung-Young Oh, Eun Jin Ha, Sang-Bae Ko, Jaeyoung Cho
Acute Crit Care. 2019;34(4):246-254.   Published online November 29, 2019
DOI: https://doi.org/10.4266/acc.2019.00668
  • 6,218 View
  • 197 Download
  • 7 Web of Science
  • 7 Crossref
AbstractAbstract PDF
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.

Citations

Citations to this article as recorded by  
  • The role of emergency medical services in the management of in-hospital emergencies: Causes and outcomes of emergency calls – A descriptive retrospective register-based study
    Henna Myrskykari, Timo Iirola, Hilla Nordquist
    Australasian Emergency Care.2024; 27(1): 42.     CrossRef
  • Effects of a Rapid Response Team on Patient Outcomes: A Systematic Review
    Qiuxia Zhang, Khuan Lee, Zawiah Mansor, Iskasymar Ismail, Yi Guo, Qiao Xiao, Poh Ying Lim
    Heart & Lung.2024; 63: 51.     CrossRef
  • Society of Critical Care Medicine Guidelines on Recognizing and Responding to Clinical Deterioration Outside the ICU: 2023
    Kimia Honarmand, Randy S. Wax, Daleen Penoyer, Geoffery Lighthall, Valerie Danesh, Bram Rochwerg, Michael L. Cheatham, Daniel P. Davis, Michael DeVita, James Downar, Dana Edelson, Alison Fox-Robichaud, Shigeki Fujitani, Raeann M. Fuller, Helen Haskell, Ma
    Critical Care Medicine.2024; 52(2): 314.     CrossRef
  • Rapid Response Systems
    Bradford D. Winters
    Critical Care Clinics.2024; 40(3): 583.     CrossRef
  • Improving sepsis recognition and management
    Merrilee I Cox, Hillary Voss
    Current Problems in Pediatric and Adolescent Health Care.2021; 51(4): 101001.     CrossRef
  • A Somogy Megyei Kaposi Mór Oktató Kórház által bevezetett gyors reagálású rendszer hatása a kórházi mortalitásra
    János Fogas, Rita Koroseczné Pavlin, Krisztina Szabó, Eszter Héra, Imre Repa, Mariann Moizs
    Orvosi Hetilap.2021; 162(20): 782.     CrossRef
  • Evidence revealed the effects of rapid response system
    Jae Hwa Cho
    Acute and Critical Care.2019; 34(4): 282.     CrossRef
Letter to the Editor
Neurology
Implication of Neurological Pupil Index for Monitoring of Brain Edema
Tae Jung Kim, Sang-Bae Ko
Acute Crit Care. 2018;33(1):57-60.   Published online February 28, 2018
DOI: https://doi.org/10.4266/acc.2017.00213
  • 9,240 View
  • 221 Download
  • 4 Web of Science
  • 6 Crossref
PDF

Citations

Citations to this article as recorded by  
  • Approaches to Consciousness Assessment in Neurocritically Ill Patients
    Dong-Wan Kang, Tae Jung Kim
    Journal of the Korean Neurological Association.2024; 42(2): 107.     CrossRef
  • Quantitative assessments of pupillary light reflexes in neurocritically ill patients
    Tae Jung Kim
    Journal of Neurocritical Care.2022; 15(2): 79.     CrossRef
  • Automated Quantitative Pupillometry in the Critically Ill
    Petra Opic, Stephan Rüegg, Stephan Marsch, Stephan Sebastian Gut, Raoul Sutter
    Neurology.2021;[Epub]     CrossRef
  • Neurological Pupil Index as an Indicator of Neurological Worsening in Large Hemispheric Strokes
    Tae Jung Kim, Soo-Hyun Park, Hae-Bong Jeong, Eun Jin Ha, Won Sang Cho, Hyun-Seung Kang, Jung Eun Kim, Sang-Bae Ko
    Neurocritical Care.2020; 33(2): 575.     CrossRef
  • Eyeing up the injured brain: automated pupillometry and optic nerve sheath diameter
    Federico Romagnosi, Filippo Bongiovanni, Mauro Oddo
    Current Opinion in Critical Care.2020; 26(2): 115.     CrossRef
  • Objective Pupillometry as an Adjunct to Prediction and Assessment for Oculomotor Nerve Injury and Recovery: Potential for Practical Applications
    Salah G. Aoun, Babu G. Welch, Michaela Cortes, Sonja E. Stutzman, Matthew C. MacAllister, Tarek Y. El Ahmadieh, Mohamed Osman, Stephen A. Figueroa, Jonathan A. White, Hunt H. Batjer, Daiwai M. Olson
    World Neurosurgery.2019; 121: e475.     CrossRef
Case Report
Liver
Brain Oxygen Monitoring via Jugular Venous Oxygen Saturation in a Patient with Fulminant Hepatic Failure
Yerim Kim, Chi Kyung Kim, Seunguk Jung, Sang-Bae Ko
Korean J Crit Care Med. 2016;31(3):251-255.   Published online August 30, 2016
DOI: https://doi.org/10.4266/kjccm.2016.00143
  • 9,921 View
  • 221 Download
  • 2 Crossref
AbstractAbstract PDF
Fulminant hepatic failure (FHF) is often accompanied by a myriad of neurologic complications, which are associated with high morbidity and mortality. Although appropriate neuromonitoring is recommended for early diagnosis and to minimize secondary brain injury, individuals with FHF usually have a high chance of coagulopathy, which limits the ability to use invasive neuromonitoring. Jugular bulb venous oxygen saturation (JvO2) monitoring is well known as a surrogate direct measures of global brain oxygen use. We report the case of a patient with increased intracranial pressure due to FHF, in which JvO2 was used for appropriate brain oxygen monitoring.

Citations

Citations to this article as recorded by  
  • Bleeding complications associated with the molecular adsorbent recirculating system: a retrospective study
    Seon Woo Yoo, Min-Jong Ki, Dal Kim, Seul Ki Kim, SeungYong Park, Hyo Jin Han, Heung Bum Lee
    Acute and Critical Care.2021; 36(4): 322.     CrossRef
  • Neurological Monitoring in Acute Liver Failure
    Alexandra S. Reynolds, Benjamin Brush, Thomas D. Schiano, Kaitlin J. Reilly, Neha S. Dangayach
    Hepatology.2019; 70(5): 1830.     CrossRef

ACC : Acute and Critical Care