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Delayed Medical Emergency Team Calls and Associated Outcomes*

Boniatti, Márcio M. PhD, MD1; Azzolini, Neusa MD2; Viana, Marina V. MD2; Ribeiro, Berenice S. P. MD2; Coelho, Renata S. MD2; Castilho, Rodrigo K. MD2; Guimarães, Márcio R. MD2; Zorzi, Lia MD2; Schulz, Luis F. MD2; Filho, Edison M. Rodrigues MD2

doi: 10.1097/CCM.0b013e31829e53b9
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Objective: To determine whether there was an association between delayed medical emergency team calls and mortality after a medical emergency team review.

Design: This was a prospective observational study.

Setting: A university-affiliated tertiary referral hospital in Porto Alegre, Brazil.

Patients: All patients were reviewed by the medical emergency team from July 2008 to December 2009.

Interventions: None.

Measurements and Main Results: There were 1,481 calls for 1,148 patients. Delayed medical emergency team calls occurred for 246 patients (21.4%). The criterion associated with delay was typically the same criterion for the subsequent medical emergency team call. Physicians had a greater prevalence of delayed medical emergency team calls (110 of 246 [44.7%]) than timely medical emergency team calls (267 of 902 [29.6%]; p < 0.001). The mortality at 30 days after medical emergency team review was higher among patients with delayed medical emergency team activation (152 [61.8%]) than patients receiving timely medical emergency team activation (378 [41.9%]; p < 0.001). In a multivariate analysis, delayed medical emergency team calls remained significantly associated with higher mortality.

Conclusions: Delayed medical emergency team calls are common and are independently associated with higher mortality. This result reaffirms the concept and need for a rapid response system.

1Critical Care Department, Hospital Nossa Senhora da Conceição, Porto Alegre, Rio Grande do Sul, Brazil.

2Critical Care Department, Santa Casa de Misericórdia, Porto Alegre, Rio Grande do Sul, Brazil.

* See also p. 195.

The authors have disclosed that they do not have any potential conflicts of interest.

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© 2014 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins