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Med J Aust. 2000 Sep;173(5):236-40.

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

Author information

  • 1Liverpool Hospital, Sydney, NSW. p.bristow@alfred.org.au

Abstract

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.

PMID:
11130346
[PubMed - indexed for MEDLINE]
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