Characteristics and outcomes of patients receiving a medical emergency team review for respiratory distress or hypotension

J Crit Care. 2008 Sep;23(3):325-31. doi: 10.1016/j.jcrc.2007.11.002. Epub 2008 Apr 18.

Abstract

Purpose: To describe the characteristics and outcomes of patients receiving a medical emergency team (MET) review for the MET syndromes of respiratory distress or hypotension and to assess the effect of delayed MET activation on their outcomes.

Materials and methods: We retrospectively analyzed the medical records of 2 cohorts of 100 patients for each of the MET syndromes of respiratory distress and hypotension. We collected information on patient demographics, comorbidities, presence of sepsis, and patient outcome. We documented the presence and duration of delayed MET activation.

Results: Patients with respiratory distress were more likely to be postoperative (40% vs 28%, P = .07), but less likely to have a history of congestive cardiac failure (12% vs 22%, P = .06). Sepsis was present in 58% of cases. The hospital mortality for MET calls due to respiratory distress and hypotension was 38% and 35%, respectively (P = .77). Delayed MET calls occurred in 50% of patients with the MET syndrome of respiratory distress and in 39% of those with hypotension (P = .11). The median duration of delay was 12 hours in patients with respiratory distress compared to 5 hours for patients with hypotension (P = .016). A delay in making a MET call was associated with an increase in mortality (odds ratio, 2.10; 95% confidence interval, 1.01-4.34; P = .045).

Conclusions: Patients receiving MET calls for respiratory distress or hypotension were elderly and had a mortality greater than 35%. In many cases, MET activation was delayed. This delay was associated with increased mortality.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • APACHE
  • Aged
  • Cohort Studies
  • Comorbidity
  • Emergency Medical Services / organization & administration
  • Emergency Medical Services / statistics & numerical data*
  • Female
  • Hospital Mortality
  • Humans
  • Hypotension / mortality
  • Hypotension / therapy*
  • Male
  • Patient Care Team / organization & administration
  • Patient Care Team / statistics & numerical data
  • Patient Transfer / organization & administration
  • Patient Transfer / statistics & numerical data
  • Respiratory Distress Syndrome, Adult / mortality
  • Respiratory Distress Syndrome, Adult / therapy*
  • Retrospective Studies
  • Sepsis / complications
  • Sepsis / mortality
  • Socioeconomic Factors
  • Time Factors
  • Treatment Outcome