Timing and Location of Medical Emergency Team Activation Is Associated with Seriousness of Outcome: An Observational Study in a Tertiary Care Hospital

PLoS One. 2016 Dec 28;11(12):e0168729. doi: 10.1371/journal.pone.0168729. eCollection 2016.


Purpose: The medical emergency team (MET) can be activated anytime and anywhere in a hospital. We hypothesized the timing and location of MET activation are associated with seriousness of outcome.

Materials and methods: We tested for an association of clinical outcomes with timing and location using a university hospital cohort in Japan (n = 328). The primary outcome was short-term serious outcome (unplanned ICU admission after MET activation or death at scene).

Results: Patients for whom the MET was activated in the evening or night-time had significantly higher rates of short-term serious outcome than those for whom it was activated during the daytime (vs. evening: adjusted OR = 2. 53, 95% CI = 1.24-5.13, P = 0.010; night-time: adjusted OR = 2.45, 95% CI = 1.09-5.50, P = 0.030). Patients for whom the MET was activated in public space had decreased short-term serious outcome compared to medical spaces (public space: adjusted OR = 0.19, 95% CI = 0.07-0.54, P = 0.0017). Night-time (vs. daytime) and medical space (vs. public space) were significantly associated with higher risks of unexpected cardiac arrest and 28-day mortality.

Conclusions: Patients for whom the MET was activated in the evening/night-time, or in medical space, had a higher rate of short-term serious outcomes. Taking measures against these risk factors may improve MET performance.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Emergency Medical Services / statistics & numerical data*
  • Female
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Patient Admission
  • Prognosis
  • Tertiary Care Centers / statistics & numerical data*
  • Time Factors

Grant support

This work was supported by the St. Luke's Life Science Institute Research grant. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.