Long-term outcomes following a rapid response team attendance

Abstract

Objective: The aim of this study was to describe the long-term results of patients needing a rapid response team (RRT) call at a university-affiliated Australian hospital that accepts quaternary referrals.

Methods: An observational study to evaluate the database of RRT for inpatients aged ≥16 years was linked to a population registry of deaths (July 2013-July 2021). Outcomes were 96-month cumulative survival, RRT call, hospital and posthospital (the period beyond hospital stay associated with RRT call) mortality, and trend over time.

Results: There were 31 447 calls to 17 349 inpatients, of whom 9274 (53.5%) were males, with a median age of 72 (interquartile range: 57-83) years. At the 96-month census point, 9317 (53.7%) patients were alive. Of the 8032 who died, 204 (2.5%) died at RRT call, 2262 (28.1%) at hospital discharge, and 5570 (69.3%) died following hospital discharge. A total of 5470 (68.1%) patients had died within 12 months of RRT call. Compared with general population deaths, RRT patients died younger (median age: 79 vs 88 years), were more likely to die in a hospital (54.6% vs 41.7%), and were less likely to die in a private location (11.9% vs 18.8%).

Discussion: Survival duration varied by RRT trigger, with the least duration observed for cardiac arrest, followed by oxygen desaturation and tachypnoea. Lesser survival duration was also observed for male patients, medical admissions, patients with multiple calls, and those with a not-for-resuscitation order. Mortality decreased over the study period, whilst the RRT dose increased.

Conclusions: Most deaths occur within 12 months of an index RRT call and following hospital discharge. RRT patients die at a younger age than the general population. Cumulative survival varied by RRT trigger and improved over time.

Keywords: General population; Medical emergency response; Medical emergency teams; Patient discharge; RRT; Rapid response systems; Rapid response teams; Registry.