The impact of delayed rapid response call activation on patient outcomes

Abstract

Purpose: To investigate the impact of delay in rapid response call (RRC) activation on Hospital mortality.

Materials and methods: This study was conducted in a university affiliated hospital providing medical, surgical, mental health, maternity, and pediatric services. RRCs were considered delayed if RRC activation was delayed by ≥15min. The primary outcome measure was in-hospital mortality. Secondary outcomes included hospital length of stay (LOS), requirement of ICU admission, as well as requirement of mechanical ventilation and ICU LOS for patients requiring ICU admission.

Results: A total of 826 RRCs occurred in 629 patient admissions. A quarter of all RRCs were delayed by ≥15min, with a median delay of 1h and 20min. Patients with a delayed RRC had significantly higher in-hospital mortality (34.7% vs. 21.2%; p=0.001,) and significantly longer hospitalizations (11.6 vs. 8.4days; p=0.036). After adjusting for confounders, RRC activation was independently associated with increased in-hospital mortality (OR=1.79; 95% CI=1.17-2.72: p=0.007).

Conclusions: A delay of ≥15min was associated with significantly increased in-hospital mortality and longer hospitalization. The factors contributing to the observed increase in mortality with delayed RRCs require further exploration.

Keywords: Delay; Hospitalization; Intensive care; Mortality; Rapid response.