A prospective before-and-after trial of a medical emergency team

Med J Aust. 2003 Sep 15;179(6):283-7. doi: 10.5694/j.1326-5377.2003.tb05548.x.


Objective: To determine the effect on cardiac arrests and overall hospital mortality of an intensive care-based medical emergency team.

Design and setting: Prospective before-and-after trial in a tertiary referral hospital.

Patients: Consecutive patients admitted to hospital during a 4-month "before" period (May-August 1999) (n = 21 090) and a 4-month intervention period (November 2000 -February 2001) (n = 20 921).

Main outcome measures: Number of cardiac arrests, number of patients dying after cardiac arrest, number of postcardiac-arrest bed-days and overall number of in-hospital deaths.

Results: There were 63 cardiac arrests in the "before" period and 22 in the intervention period (relative risk reduction, RRR: 65%; P < 0.001). Thirty-seven deaths were attributed to cardiac arrests in the "before" period and 16 in the intervention period (RRR: 56%; P = 0.005). Survivors of cardiac arrest in the "before" period required 163 ICU bed-days versus 33 in the intervention period (RRR: 80%; P < 0.001), and 1353 hospital bed-days versus 159 in the intervention period (RRR: 88%; P < 0.001). There were 302 deaths in the "before" period and 222 in the intervention period (RRR: 26%; P = 0.004).

Conclusions: The incidence of in-hospital cardiac arrest and death following cardiac arrest, bed occupancy related to cardiac arrest, and overall in-hospital mortality decreased after introducing an intensive care-based medical emergency team.

Publication types

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

MeSH terms

  • Aged
  • Critical Care / organization & administration
  • Emergency Medical Services / organization & administration*
  • Female
  • Heart Arrest / mortality
  • Heart Arrest / prevention & control*
  • Heart Arrest / therapy
  • Hospital Mortality
  • Hospitals, Teaching
  • Humans
  • Male
  • Patient Care Team*
  • Prospective Studies