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Rapid Response System Should Be Enhanced at Non-general Ward Locations: a Retrospective Multicenter Cohort Study in Korea

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Abstract
Background: A rapid response system (RRS) contributes to the safety of hospitalized patients. Clinical deterioration may occur in the general ward (GW) or in non-GW locations such as radiology or dialysis units. However, there are few studies regarding RRS activation in non-GW locations. This study aimed to compare the clinical characteristics and outcomes of patients with RRS activation in non-OW locations and in the GW.

Methods: From January 2016 to December 2017, all patients requiring RRS activation in nine South Korean hospitals were retrospectively enrolled and classified according to RRS activation location: GW vs non-GW RRS activations.

Results: In total, 12,793 patients were enrolled; 222 (1.7%) were non-GW RRS activations. There were more instances of shock (11.6% vs. 18.5%) and cardiac arrest (2.7% vs. 22.5%) in non-GW RRS activation patients. These patients also had a lower oxygen saturation (92.6% +/- 8.6% vs. 88.7% +/- 14.3%, P< 0.001) and a higher National Early Warning Score 2 (7.5 +/- 3.4 vs. 8.9 +/- 3.8, P< 0.001) than GW RRS activation patients. Although non-GW RRS activation patients received more intubation (odds ratio [OR], 3.135; P< 0.001), advanced cardiovascular life support (OR, 3.912; P < 0.001), and intensive care unit transfer (OR, 2.502; P< 0.001), their hospital mortality (hazard ratio, 0.630; P= 0.013) was lower than GW RRS activation patients upon multivariate analysis.

Conclusion: Considering that there were more critically ill but recoverable cases in non-GW locations, active RRS involvement should be required in such locations.
Author(s)
강병주안종준홍상범Dong Hyun LeeJae Young MoonJisoo ParkJung Soo KimKyeongman JeonSang-Min LeeYeon Joo Lee
Issued Date
2021
Type
Article
Keyword
Heart ArrestHospital Rapid Response TeamIntensive Care UnitsOriginalPatients' RoomsShock의학일반
DOI
10.3346/jkms.2021.36.e7
URI
https://oak.ulsan.ac.kr/handle/2021.oak/6979
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_nrf_kci_oai_kci_go_kr_ARTI_9668823&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Rapid%20Response%20System%20Should%20Be%20Enhanced%20at%20Non-general%20Ward%20Locations:%20a%20Retrospective%20Multicenter%20Cohort%20Study%20in%20Korea&amp;offset=0&amp;pcAvailability=true
Publisher
JOURNAL OF KOREAN MEDICAL SCIENCE
Location
대한민국
Language
영어
ISSN
1011-8934
Citation Volume
36
Citation Number
2
Citation Start Page
0
Citation End Page
0
Appears in Collections:
Medicine > Medicine
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