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Abstract：
Study the incidence and reasons behind in-hospital cardiac arrests (IHCAs) after rapid response team (RRT) reviews.
We conducted a matched case-control study at Tampere University Hospital, Finland. Data on adult patients who were triaged to remain on general ward after first (index) RRT review without treatment limitations but who suffered an IHCA within the following 48 h were prospectively collected for 5.3 years. These cases were matched (age ±3 years, sex, surgical/medical ward, admission year) at a 1:4 ratio to controls (no ICHA after RRT review).
Of 2653 index RRT reviews, 17 patients suffered an IHCA on general ward within the 48 h after review. Their 30-day mortality rate was 88%. The incidence was 6.3/1000 index RRT reviews or 4.6/100,000 hospital admissions. Patients who suffered an IHCA within 48 h after RRT review were more likely to have a preceding ICU admission, and their median national early warning scores (NEWSs) at the end of the index RRT reviews (=last NEWSs) were higher than those of the controls. Higher last NEWS was the only factor associated with ICHA after RRT review (OR 1.22, 95% CI 1.00-1.49, p = 0.048) in a conditional multivariable regression model.
IHCA within 48 h after an index RRT review on general ward is a rare event with poor prognosis. It is independently associated with higher NEWS at the end of the index RRT review. Careful consideration is stressed, when patients with high NEWS are left on ward after RRT reviews.
We conducted a matched case-control study at Tampere University Hospital, Finland. Data on adult patients who were triaged to remain on general ward after first (index) RRT review without treatment limitations but who suffered an IHCA within the following 48 h were prospectively collected for 5.3 years. These cases were matched (age ±3 years, sex, surgical/medical ward, admission year) at a 1:4 ratio to controls (no ICHA after RRT review).
Of 2653 index RRT reviews, 17 patients suffered an IHCA on general ward within the 48 h after review. Their 30-day mortality rate was 88%. The incidence was 6.3/1000 index RRT reviews or 4.6/100,000 hospital admissions. Patients who suffered an IHCA within 48 h after RRT review were more likely to have a preceding ICU admission, and their median national early warning scores (NEWSs) at the end of the index RRT reviews (=last NEWSs) were higher than those of the controls. Higher last NEWS was the only factor associated with ICHA after RRT review (OR 1.22, 95% CI 1.00-1.49, p = 0.048) in a conditional multivariable regression model.
IHCA within 48 h after an index RRT review on general ward is a rare event with poor prognosis. It is independently associated with higher NEWS at the end of the index RRT review. Careful consideration is stressed, when patients with high NEWS are left on ward after RRT reviews.
摘要：
在快速反应小组（RRT）审查后，研究院内心脏骤停（IHCA）的发生率和原因。
我们在坦佩雷大学医院进行了一项配对病例对照研究，芬兰。前瞻性收集了5.3年的成年患者的数据，这些患者在首次（索引）RRT审查后没有治疗限制，但在随后的48小时内遭受IHCA。这些病例匹配（年龄±3岁，性别,外科/内科病房,入院年）与对照组的比例为1：4（RRT审查后无ICHA）。
在2653个索引RRT评论中，17例患者在复查后48小时内在普通病房接受了IHCA。30天死亡率为88%。发生率为6.3/1000指数RRT评论或4.6/100,000住院。在RRT检查后48小时内患有IHCA的患者更有可能在ICU入院之前。在索引RRT评论（=最后的NEWS）结束时，他们的国家预警评分中位数（NEWS）高于对照组。在条件多变量回归模型中，较高的最后新闻是RRT审查后与ICHA相关的唯一因素（OR1.22，95％CI1.00-1.49，p=0.048）。
在普通病房进行索引性RRT检查后48小时内的IHCA是罕见的事件，预后不良。在索引RRT审查结束时，它与更高的新闻独立相关。强调仔细考虑，当新闻较高的患者在RRT审查后留在病房时。
我们在坦佩雷大学医院进行了一项配对病例对照研究，芬兰。前瞻性收集了5.3年的成年患者的数据，这些患者在首次（索引）RRT审查后没有治疗限制，但在随后的48小时内遭受IHCA。这些病例匹配（年龄±3岁，性别,外科/内科病房,入院年）与对照组的比例为1：4（RRT审查后无ICHA）。
在2653个索引RRT评论中，17例患者在复查后48小时内在普通病房接受了IHCA。30天死亡率为88%。发生率为6.3/1000指数RRT评论或4.6/100,000住院。在RRT检查后48小时内患有IHCA的患者更有可能在ICU入院之前。在索引RRT评论（=最后的NEWS）结束时，他们的国家预警评分中位数（NEWS）高于对照组。在条件多变量回归模型中，较高的最后新闻是RRT审查后与ICHA相关的唯一因素（OR1.22，95％CI1.00-1.49，p=0.048）。
在普通病房进行索引性RRT检查后48小时内的IHCA是罕见的事件，预后不良。在索引RRT审查结束时，它与更高的新闻独立相关。强调仔细考虑，当新闻较高的患者在RRT审查后留在病房时。
