Association between implementation of an intensivist-led medical emergency team and mortality.

Abstract:

PURPOSE:To evaluate the impact of implementation of a dedicated intensivist-led medical emergency team (IL-MET) on mortality in patients admitted to the intensive care unit (ICU). METHODS:All adult ward admissions to the ICU between July 2002 and December 2009 were reviewed (n=1920) after excluding readmissions and admissions for <24 h. IL-MET hours were defined as 8:00-15:59 (Monday to Friday). The following periods were analysed: period 1: 1 July 2002-31 August 2004 (control); period 2: 1 September 2004-11 February 2007 (partial MET without dedicated intensivist); and period 3: 12 February 2007-31 December 2009 (hospital-wide IL-MET). RESULTS:During all three periods, there were no significant differences in length of stay or mortality (IL-MET vs non-IL-MET hours, p>0.1 for all). On multivariate analysis, Acute Physiology and Chronic Health Evaluation (APACHE) II score and age were independently associated with mortality in all three periods (p<0.05 for all). During period 3, there was a non-significant trend towards decreased mortality if admitted during IL-MET hours (OR 0.73, 95% CI 0.51 to 1.03, p=0.08). During period 3, there was a non-significant trend towards decreased mortality if admitted during IL-MET hours (OR 0.73, 95% CI 0.51 to 1.03, p=0.08). However, this result likely reflects the observed increase in mortality during non-IL MET hours rather than improved mortality during IL-MET hours. CONCLUSION In a single centre experience, implementation of an IL-MET did not reduce the rate of in-hospital death or lengths of stay.

journal_name

BMJ Qual Saf

journal_title

BMJ quality & safety

authors

Karvellas CJ,de Souza IA,Gibney RT,Bagshaw SM

doi

10.1136/bmjqs-2011-000393

subject

Has Abstract

pub_date

2012-02-01 00:00:00

pages

152-9

issue

2

eissn

2044-5415

issn

2044-5423

pii

bmjqs-2011-000393

journal_volume

21

pub_type

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