J Clin Outcomes Manage
Demographic and clinical characteristics of responders and nonresponders to rapid response team interventions
Kolluru A, Singh T, Kanwar M, Szpunar S, Saravolatz LD
Abstract Objective: To determine the demographic and clinical characteristics of individuals who were responders and nonresponders to a Rapid Response Team (RRT) intervention. Methods: We examined the charts of patients aged 18 and older who had an RRT intervention in 2007 (n = 380). “Responders” were patients who stabilized on the floor. Nonresponders were patients who did not stabilize on the floor and went to the intensive care unit (ICU) or had a cardiac arrest on the floor. Data were analyzed using chi-squared analysis, ANOVA, Student’s t test, and logistic regression. Results: The mean age of RRT patients was 67.3 years, 50.3% were male, and 48.6% were African American. Overall, 51.5% of patients were responders. Of the nonresponders, 62% went to the ICU and were discharged, 24% went to the ICU and died, and 14% died on the floor. A respiratory admission diagnosis increased the odds of being a nonresponder (odds ratio [OR], 1.8; p = 0.06). Breathing treatment reduced the odds of nonresponse (OR, 0.41; p = 0.03). Oxygen desaturation as the reason for the RRT increased the odds of being a nonresponder (OR, 2.6; p = 0.001). If “staff concerned” was the reason for the RRT, patients were more likely to respond (OR = 0.23; p = 0.025). Conclusion: Early recognition of patient deterioration (staff concern) as well as closer monitoring and aggressive therapy of patients admitted with a respiratory diagnosis may lead to a more favorable RRT outcome for hospitalized patients.
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