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Effect of the medical emergency team on long-term mortality following major surgery
INTRODUCTION: Introducing an intensive care unit (ICU)-based medical emergency team (MET) into our hospital was associated with decreased postoperative in-hospital mortality after major surgery. The purpose of the present study was to assess the effect of the MET and other variables on long-term mor...
Autores principales: | , , , |
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Formato: | Texto |
Lenguaje: | English |
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BioMed Central
2007
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2151897/ https://www.ncbi.nlm.nih.gov/pubmed/17257444 http://dx.doi.org/10.1186/cc5673 |
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author | Jones, Daryl Egi, Moritoki Bellomo, Rinaldo Goldsmith, Donna |
author_facet | Jones, Daryl Egi, Moritoki Bellomo, Rinaldo Goldsmith, Donna |
author_sort | Jones, Daryl |
collection | PubMed |
description | INTRODUCTION: Introducing an intensive care unit (ICU)-based medical emergency team (MET) into our hospital was associated with decreased postoperative in-hospital mortality after major surgery. The purpose of the present study was to assess the effect of the MET and other variables on long-term mortality in this patient population. METHODS: We conducted a prospective, controlled, before-and-after trial in a University-affiliated hospital. Participants included consecutive patients admitted for major surgery (surgery requiring hospital stay > 48 hours) during a four month control phase and a four month MET phase. The intervention involved the introduction of a hospital-wide ICU-based MET service to evaluate and treat ward patients with acutely deranged vital signs. Information on long-term mortality was obtained from the Australian death registry. The main outcome measure was patient mortality at 1500 days. Data on patient demographics, surgery undertaken and whether the surgery was scheduled or unscheduled was obtained from the hospital electronic database. Multivariable analysis was conducted to determine independent predictors of 1500-day mortality. RESULTS: There were 1,369 major operations in 1,116 patients during the control period and 1,313 operations in 1,067 patients during the MET (intervention) period. Overall survival at 1500 days was 65.8% in the control period and 71.6% during the MET period (P = 0.001). Patients in the control phase were statistically less likely to be admitted under orthopaedic surgery, urology and faciomaxillary surgery units, but more likely to be admitted under cardiac surgery or neurosurgery units. Patients in the MET period were less likely to undergo unscheduled surgery. Multivariable analysis revealed that age, unscheduled surgery and admission under thoracic surgery, neurosurgery, oncology and general medicine were independent predictors of increased 1500-day mortality. Admission during the MET period was also an independent predictor of decreased 1500-day mortality (odds ratio 0.74; P = 0.005). CONCLUSION: Introduction of a MET service in a teaching hospital was associated with increased long-term survival even after adjusting for other factors that contribute to long-term surgical mortality. |
format | Text |
id | pubmed-2151897 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2007 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-21518972007-12-25 Effect of the medical emergency team on long-term mortality following major surgery Jones, Daryl Egi, Moritoki Bellomo, Rinaldo Goldsmith, Donna Crit Care Research INTRODUCTION: Introducing an intensive care unit (ICU)-based medical emergency team (MET) into our hospital was associated with decreased postoperative in-hospital mortality after major surgery. The purpose of the present study was to assess the effect of the MET and other variables on long-term mortality in this patient population. METHODS: We conducted a prospective, controlled, before-and-after trial in a University-affiliated hospital. Participants included consecutive patients admitted for major surgery (surgery requiring hospital stay > 48 hours) during a four month control phase and a four month MET phase. The intervention involved the introduction of a hospital-wide ICU-based MET service to evaluate and treat ward patients with acutely deranged vital signs. Information on long-term mortality was obtained from the Australian death registry. The main outcome measure was patient mortality at 1500 days. Data on patient demographics, surgery undertaken and whether the surgery was scheduled or unscheduled was obtained from the hospital electronic database. Multivariable analysis was conducted to determine independent predictors of 1500-day mortality. RESULTS: There were 1,369 major operations in 1,116 patients during the control period and 1,313 operations in 1,067 patients during the MET (intervention) period. Overall survival at 1500 days was 65.8% in the control period and 71.6% during the MET period (P = 0.001). Patients in the control phase were statistically less likely to be admitted under orthopaedic surgery, urology and faciomaxillary surgery units, but more likely to be admitted under cardiac surgery or neurosurgery units. Patients in the MET period were less likely to undergo unscheduled surgery. Multivariable analysis revealed that age, unscheduled surgery and admission under thoracic surgery, neurosurgery, oncology and general medicine were independent predictors of increased 1500-day mortality. Admission during the MET period was also an independent predictor of decreased 1500-day mortality (odds ratio 0.74; P = 0.005). CONCLUSION: Introduction of a MET service in a teaching hospital was associated with increased long-term survival even after adjusting for other factors that contribute to long-term surgical mortality. BioMed Central 2007 2007-01-29 /pmc/articles/PMC2151897/ /pubmed/17257444 http://dx.doi.org/10.1186/cc5673 Text en Copyright © 2007 Jones et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Jones, Daryl Egi, Moritoki Bellomo, Rinaldo Goldsmith, Donna Effect of the medical emergency team on long-term mortality following major surgery |
title | Effect of the medical emergency team on long-term mortality following major surgery |
title_full | Effect of the medical emergency team on long-term mortality following major surgery |
title_fullStr | Effect of the medical emergency team on long-term mortality following major surgery |
title_full_unstemmed | Effect of the medical emergency team on long-term mortality following major surgery |
title_short | Effect of the medical emergency team on long-term mortality following major surgery |
title_sort | effect of the medical emergency team on long-term mortality following major surgery |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2151897/ https://www.ncbi.nlm.nih.gov/pubmed/17257444 http://dx.doi.org/10.1186/cc5673 |
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