Rates of in-hospital arrests, deaths and intensive care admissions: the effect of a medical emergency team

Med J Aust. 2000 Sep;173(5):236-40. doi: 10.5694/j.1326-5377.2000.tb125627.x.


Objectives: To evaluate the effectiveness of a medical emergency team (MET) in reducing the rates of selected adverse events.

Design: Cohort comparison study after casemix adjustment.

Patients and setting: All adult (> or = 14 years) patients admitted to three Australian public hospitals from 8 July to 31 December 1996. INTERVENTION STUDIED: At Hospital 1, a medical emergency team (MET) could be called for abnormal physiological parameters or staff concern. Hospitals 2 and 3 had conventional cardiac arrest teams.

Main outcome measures: Casemix-adjusted rates of cardiac arrest, unanticipated admission to intensive care unit (ICU), death, and the subgroup of deaths where there was no pre-existing "do not resuscitate" (DNR) order documented.

Results: There were 1510 adverse events identified among 50 942 admissions. The rate of unanticipated ICU admissions was less at the intervention hospital in total (casemix-adjusted odds ratios: Hospital 1, 1.00; Hospital 2, 1.59 [95% CI, 1.24-2.04]; Hospital 3, 1.73 [95% CI, 1.37-2.16]). There was no significant difference in the rates of cardiac arrest or total deaths between the three hospitals. However, one of the hospitals with a conventional cardiac arrest team had a higher death rate among patients without a DNR order.

Conclusions: The MET hospital had fewer unanticipated ICU/HDU admissions, with no increase in in-hospital arrest rate or total death rate. The non-DNR deaths were lower compared with one of the other hospitals; however, we did not adjust for DNR practices. We suggest that the MET concept is worthy of further study.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Australia / epidemiology
  • Cohort Studies
  • Emergencies
  • Emergency Service, Hospital
  • Female
  • Heart Arrest / epidemiology*
  • Hospital Mortality*
  • Humans
  • Intensive Care Units / statistics & numerical data*
  • Male
  • Middle Aged
  • Odds Ratio
  • Outcome Assessment, Health Care*
  • Patient Care Team / organization & administration*
  • Patient Transfer / statistics & numerical data
  • Prevalence
  • Risk Adjustment