The characteristics, types of intervention, and outcomes of postoperative patients who required rapid response system intervention: a nationwide database analysis.

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Abstrakt

Tytuł:: The characteristics, types of intervention, and outcomes of postoperative patients who required rapid response system intervention: a nationwide database analysis.
Autorzy:: Sento Y; Department of Anesthesiology and Intensive Care Medicine, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan. .
Arai M; Division of Intensive Care Medicine, Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan.
Yamamori Y; Department of Emergency and Critical Care Medicine, Shimane Prefectural Central Hospital, 4-1-1 Himebara, Izumo, Shimane, 693-8555, Japan.
Fujiwara S; Department of Emergency Medicine, NHO Ureshino Medical Center, 2436 Shimojuku, Ureshino, Saga, 843-0393, Japan.
Tamashiro M; Department of Intensive Care Medicine, Tomishiro Central Hospital, 25 Ueta, Tomigusuku, Okinawa, 901-0243, Japan.
Kawamoto E; Department of Emergency and Disaster Medicine, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
Naito T; Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan.
Atagi K; Intensive Care Unit, Nara Prefecture General Medical Center, 2-897-5 Shichijonishi, Nara, Nara, 630-8581, Japan.
Fujitani S; Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan.
Osaga S; Clinical Research Management Center, Nagoya City University Hospital, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
Sobue K; Department of Anesthesiology and Intensive Care Medicine, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
Corporate Authors:: In-Hospital Emergency Study Group
Źródło:: Journal of anesthesia [J Anesth] 2021 Apr; Vol. 35 (2), pp. 222-231. Date of Electronic Publication: 2021 Feb 01.
Typ publikacji:: Journal Article; Research Support, Non-U.S. Gov't
Język:: English
Imprint Name(s):: Publication: Tokyo : Springer International for the Japan Society of Anesthesiology
Original Publication: [Tokyo] : Japan Society of Anesthesiology, [1987-
MeSH Terms:: Hospital Rapid Response Team*
Hospital Mortality ; Humans ; Japan/epidemiology ; Postoperative Period ; Retrospective Studies
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Contributed Indexing:: Keywords: Medical emergency team; Patient safety; Postanesthesia care; Postoperative care; Serious adverse event
Entry Date(s):: Date Created: 20210201 Date Completed: 20210423 Latest Revision: 20210424
Update Code:: 20240104
PubMed Central ID:: PMC7969491
DOI:: 10.1007/s00540-021-02900-4
PMID:: 33523292
: Czasopismo naukowe

Pełny tekst

Purpose: Improving the safety of general wards is a key to reducing serious adverse events in the postoperative period. We investigated the characteristics, treatment, and outcomes of postoperative patients managed by a rapid response system (RRS) in Japan to improve postoperative management.
Methods: This retrospective study analyzed cases requiring RRS intervention that were included in the In-Hospital Emergency Registry in Japan. We analyzed data reported by 34 Japanese hospitals between January 2014 and March 2018, mainly focusing on postoperative patients for whom the RRS was activated within 7 days of surgery. Non-postoperative patients, for whom the RRS was activated in all other settings, were used for comparison as necessary.
Results: There were 609 (12.7%) postoperative patients among the total patients in the registry. The major criteria were staff concerns (30.2%) and low oxygen saturation (29.7%). Hypotension, tachycardia, and inability to contact physicians were observed as triggers significantly more frequently in postoperative patients when compared with non-postoperative patients. Among RRS activations within 7 days of surgery, 68.9% of activations occurred within postoperative day 3. The ordering of tests (46.8%) and fluid bolus (34.6%) were major interventions that were performed significantly more frequently in postoperative patients when compared with non-postoperative patients. The rate of RRS activations resulting in ICU care was 32.8%. The mortality rate at 1 month was 16.2%.
Conclusion: Approximately, 70% of the RRS activations occurred within postoperative day 3. Circulatory problems were a more frequent cause of RRS activation in the postoperative group than in the non-postoperative group.

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