A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä

Medical emergency team activation: performance of conventional dichotomised criteria versus national early warning score




TekijätTirkkonen J, Olkkola KT, Huhtala H, Tenhunen J, Hoppu S

KustantajaWILEY-BLACKWELL

KustannuspaikkaHOBOKEN; 111 RIVER ST, HOBOKEN 07030-5774, NJ USA

Julkaisuvuosi2014

JournalActa Anaesthesiologica Scandinavica

Tietokannassa oleva lehden nimiActa Anaesthesiologica Scandinavica

Lehden akronyymiActa Anaesthesiol.Scand.

Vuosikerta58

Numero4

Aloitussivu411

Lopetussivu419

Sivujen määrä9

ISSN0001-5172

DOIhttps://doi.org/10.1111/aas.12277


Tiivistelmä

BackgroundTo activate the hospital's medical emergency team (MET), either conventional dichotomised activation criteria or an early warning scoring system may be used. The relative performance of these different activation patterns to discriminate high risk patients in a heterogenic general ward population after adjustment for multiple confounding factors has not been evaluated. We aimed to evaluate the dichotomised activation criteria used at our institution and the recently published national early warning score (NEWS, United Kingdom). Materials and MethodsProspective point prevalence study at a university hospital in Finland. On two separate days, the vital signs of all adult patients without treatment limitations were measured. Data on cumulative comorbidity (Charlson comorbidity index), age, gender, admission characteristics and subsequent mortality were collected. Univariate and multivariate logistic regression models were used for unadjusted and adjusted performance testing. ResultsThe cohort consisted of 615 patients. The dichotomised activation criteria were not associated with in-hospital serious adverse events (odds ratio 1.87, 95% confidence interval 0.55-6.30) or 30-day mortality (2.13, 0.79-5.72) after adjustments. For a NEWS of seven or more (the suggested trigger level for immediate MET activation), the adjusted odds ratios for the above mentioned outcomes were 7.45 (2.39-23.3) and 11.4 (4.40-29.6), respectively. Unlike the dichotomised activation criteria, NEWS was also independently associated with a higher 60- and 180-day mortality after adjustments. ConclusionsNEWS discriminates high risk patients in a heterogenic general ward population independently of multiple confounding factors. The conventional dichotomised activation criteria were not able to detect high risk patients.




Last updated on 2024-26-11 at 18:53