Open AccessFirst report based on the online registry of a Japanese multicenter rapid response system: a descriptive study of 35 institutions in Japan
Author(s) -
Naito Takaki,
Fujiwara Shinsuke,
Kawasaki Tatsuya,
Sento Yoshiki,
Nakada Takaaki,
Arai Masayasu,
Atagi Kazuaki,
Fujitani Shigeki
Publication year - 2019
Publication title -
acute medicine and surgery
Language(s) - English
Resource type - Journals
ISSN - 2052-8817
DOI - 10.1002/ams2.454
Subject(s) - medicine , observational study , epidemiology , rapid response team , emergency medicine , comorbidity , intensive care , intervention (counseling) , mortality rate , relative risk , demography , medical emergency , intensive care medicine , nursing , confidence interval , sociology
Aim Although the concept of a rapid response system ( RRS ) has been gradually accepted in Japan, detailed information on the Japanese RRS is not well known. We provide the first report of the RRS epidemiological situation based on 4 years of RRS online registry data. Methods This is a prospective observational study. All patients registered between January 2014 and March 2018 were eligible for this study. Data related to RRS including physiological measurements were recorded. The mortality rates after rapid response team/medical emergency team ( RRT / MET ) intervention and after 30 days were recorded as outcomes. Results In total, 6,784 cases were registered at 35 facilities. Cancer (23.1%) was the most common existing comorbidity. Limitation of medical treatment was identified in 12.7% of the cases. The respiratory category was most frequently activated in 41.3% of the cases. Only two institutions had received more than 15 calls per 1,000 admissions. During RRT / MET intervention, death occurred in 3.6% and transfers to intensive care units occurred in 28.2% of the cases. After 30 days, the mortality rate was significantly higher in the night than in the day shift (30.7% versus 20.4%, respectively, P < 0.01). Conclusions We report the first epidemiological study of RRS in Japan. Japanese facilities had a very low rate of RRT / MET calls and a higher mortality rate in the night than in the day shift. Further promotion to increase the number of calls and implementation of a 24‐h RRT / MET is required.