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. 2025 Jun 2;20(5):e0324831.
doi: 10.1371/journal.pone.0324831. eCollection 2025.

The critical role of timely medical emergency team activation in oncological and non-oncological patients

Kaspar F Bachmann  1 , Samuel J Michimura  1 , Luca Cioccari  1   2 , Joerg C Schefold  1 , Anna S Messmer  1
Affiliations

The critical role of timely medical emergency team activation in oncological and non-oncological patients

Kaspar F Bachmann et al. PLoS One. .

Abstract

Purpose: This study aimed to analyse the impact of time from first physiological derangement (positive Vital Sign Score, VSS) to Medical Emergency Team (MET) activation on mortality in oncological versus non-oncological patients.

Methods: All in-hospital patients requiring a MET assessment were included. The primary outcome was 30-day mortality. Subanalyses were performed for the population that was admitted to the ICU as well as the subgroups of oncological with solid vs. haematological cancer. In addition, we assessed the number and time points of VSS measurements in oncological and non-oncological patients.

Results: 286 out of 4068 (8.9%) documented MET calls were attributed to oncological patients. Each hour delay from first abnormal VSS to MET activation was associated with an 3% increase in adjusted 30-day all-cause mortality odds (OR 1.03, 95% CI 1.02-1.05, p < 0.001), independent of oncological status (interaction p = 0.141). Oncological patients had a significantly higher number of vital sign measurements on the ward (median 24 [16-37] vs 18 [10-27], p < 0.001) before MET activation, and higher 30-day all-cause mortality (38.1% vs 21.8%, p < 0.001).

Conclusions: Although the overall outcome did not differ between, oncological patients comprised 10% of MET calls, had higher mortality and had significantly more frequent vital sign monitoring, reflecting greater clinical concern. Tailored monitoring including early MET review has potential to improve outcomes particularly in high-risk oncological patients.

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Conflict of interest statement

I have read the journal's policy and the authors of this manuscript have the following competing interests: Anna Messmer, Kaspar Bachmann and Joerg Schefold are affiliated with the Department of Intensive Care Medicine, which reports grants from Orion Pharma, Abbott Nutrition International, B. Braun Medical AG, CSEM AG, Edwards Lifesciences Services GmbH, Kenta Biotech Ltd, Maquet Critical Care AB, Omnicare Clinical Research AG, Nestle, Pierre Fabre Pharma AG, Pfizer, Bard Medica S.A., Abbott AG, Anandic Medical Systems, Pan Gas AG Healthcare, Bracco, Hamilton Medical AG, Fresenius Kabi, Getinge Group Maquet AG, Dräger AG, Teleflex Medical GmbH, Glaxo Smith Kline, Merck Sharp and Dohme AG, Eli Lilly and Company, Baxter, Astellas, Astra Zeneca, CSL Behring, Novartis, Covidien, Phagenesis, Cytel, and Nycomed outside the submitted work. The money was paid into departmental funds; no personal financial gain applied. Luca Cioccari has received educational grants from Hamilton Medical and speaker fees from OrphaSwiss, not related to this work. All other authors have nothing to disclose. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Study flowchart.
Fig 2
Fig 2. Log-rank test for the probability of MET after the first abnormal VSS.
Fig 3
Fig 3. Logistic regression model for the two groups and the primary outcome 30- day mortality
Legend: Predicted mortality in the total population as a function of hours since first abnormal VSS until MET activation, predicted for oncological and non-oncological patients according to the estimates provided in Table 2. The prediction assumes a median age of 69 years and a medical admission type.
See this image and copyright information in PMC

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