First report based on the online registry of a Japanese multicenter rapid response system: a descriptive study of 35 institutions in Japan. Issue 1 (8th September 2019)

• Record Type: Journal Article
• Authors: Naito, Takaki; Fujiwara, Shinsuke; Kawasaki, Tatsuya; Sento, Yoshiki; Nakada, Taka‐aki; Arai, Masayasu; Atagi, Kazuaki; Fujitani, Shigeki
• Other Names: Fujimoto Yoshihisa investigator.; Arimoto Hideki investigator.; Kawamoto Eiji investigator.; Hayashi Toshimasa investigator.; Yamanoue Takao investigator.; Kawamura Natsuo investigator.; Kawase Yuta investigator.; Nagata Kazuma investigator.; Saito Takuro investigator.; Tamashiro Masahiro investigator.; Aoki Kazuhiro investigator.; Miyawaki Atsushi investigator.; Shibata Naoaki investigator.; Masuyama Tomoyuki investigator.; Suzaki Shinichiro investigator.; Oka Toshiaki investigator.; Ikeda Tomoyuki investigator.; Ouchi Kazuo investigator.; Yamamori Yuji investigator.; Hayashi Yoshiro investigator.; Otake Takanao investigator.; Aoyama Takeshi investigator.; Tobe Masaru investigator.; Fujiwara Toshifumi investigator.; Sekine Ryosuke investigator.; Miyake Kentaro investigator.
• Is Part Of: Acute medicine & surgery. Volume 7:Issue 1(2020)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2019-09-08
• Subjects: in‐hospital cardiac arrest -- medical emergency team -- rapid response system -- rapid response team -- unplanned ICU admission; Surgery -- Periodicals; Medical emergencies -- Periodicals; 617.005
• DOI: 10.1002/ams2.454
• Languages: English
• ISSNs: 2052-8817

Abstract

Abstract : 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. Abstract : Japanese facilities had a low rate of rapid response team/medical emergency team calls. Mortality rate was significantly higher in the night than in the day shift. Increasing calls and 24‐h availability of rapid response teams/medical emergency teams is needed.