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The characteristics, types of intervention, and outcomes of postoperative patients who required rapid response system intervention: a nationwide database analysis
PURPOSE: Improving the safety of general wards is a key to reducing serious adverse events in the postoperative period. We investigated the characteristics, treatment, and outcomes of postoperative patients managed by a rapid response system (RRS) in Japan to improve postoperative management. METHOD...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Singapore
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7969491/ https://www.ncbi.nlm.nih.gov/pubmed/33523292 http://dx.doi.org/10.1007/s00540-021-02900-4 |
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author | Sento, Yoshiki Arai, Masayasu Yamamori, Yuji Fujiwara, Shinsuke Tamashiro, Masahiro Kawamoto, Eiji Naito, Takaki Atagi, Kazuaki Fujitani, Shigeki Osaga, Satoshi Sobue, Kazuya |
author_facet | Sento, Yoshiki Arai, Masayasu Yamamori, Yuji Fujiwara, Shinsuke Tamashiro, Masahiro Kawamoto, Eiji Naito, Takaki Atagi, Kazuaki Fujitani, Shigeki Osaga, Satoshi Sobue, Kazuya |
author_sort | Sento, Yoshiki |
collection | PubMed |
description | PURPOSE: Improving the safety of general wards is a key to reducing serious adverse events in the postoperative period. We investigated the characteristics, treatment, and outcomes of postoperative patients managed by a rapid response system (RRS) in Japan to improve postoperative management. METHODS: This retrospective study analyzed cases requiring RRS intervention that were included in the In-Hospital Emergency Registry in Japan. We analyzed data reported by 34 Japanese hospitals between January 2014 and March 2018, mainly focusing on postoperative patients for whom the RRS was activated within 7 days of surgery. Non-postoperative patients, for whom the RRS was activated in all other settings, were used for comparison as necessary. RESULTS: There were 609 (12.7%) postoperative patients among the total patients in the registry. The major criteria were staff concerns (30.2%) and low oxygen saturation (29.7%). Hypotension, tachycardia, and inability to contact physicians were observed as triggers significantly more frequently in postoperative patients when compared with non-postoperative patients. Among RRS activations within 7 days of surgery, 68.9% of activations occurred within postoperative day 3. The ordering of tests (46.8%) and fluid bolus (34.6%) were major interventions that were performed significantly more frequently in postoperative patients when compared with non-postoperative patients. The rate of RRS activations resulting in ICU care was 32.8%. The mortality rate at 1 month was 16.2%. CONCLUSION: Approximately, 70% of the RRS activations occurred within postoperative day 3. Circulatory problems were a more frequent cause of RRS activation in the postoperative group than in the non-postoperative group. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00540-021-02900-4. |
format | Online Article Text |
id | pubmed-7969491 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Singapore |
record_format | MEDLINE/PubMed |
spelling | pubmed-79694912021-04-01 The characteristics, types of intervention, and outcomes of postoperative patients who required rapid response system intervention: a nationwide database analysis Sento, Yoshiki Arai, Masayasu Yamamori, Yuji Fujiwara, Shinsuke Tamashiro, Masahiro Kawamoto, Eiji Naito, Takaki Atagi, Kazuaki Fujitani, Shigeki Osaga, Satoshi Sobue, Kazuya J Anesth Original Article PURPOSE: Improving the safety of general wards is a key to reducing serious adverse events in the postoperative period. We investigated the characteristics, treatment, and outcomes of postoperative patients managed by a rapid response system (RRS) in Japan to improve postoperative management. METHODS: This retrospective study analyzed cases requiring RRS intervention that were included in the In-Hospital Emergency Registry in Japan. We analyzed data reported by 34 Japanese hospitals between January 2014 and March 2018, mainly focusing on postoperative patients for whom the RRS was activated within 7 days of surgery. Non-postoperative patients, for whom the RRS was activated in all other settings, were used for comparison as necessary. RESULTS: There were 609 (12.7%) postoperative patients among the total patients in the registry. The major criteria were staff concerns (30.2%) and low oxygen saturation (29.7%). Hypotension, tachycardia, and inability to contact physicians were observed as triggers significantly more frequently in postoperative patients when compared with non-postoperative patients. Among RRS activations within 7 days of surgery, 68.9% of activations occurred within postoperative day 3. The ordering of tests (46.8%) and fluid bolus (34.6%) were major interventions that were performed significantly more frequently in postoperative patients when compared with non-postoperative patients. The rate of RRS activations resulting in ICU care was 32.8%. The mortality rate at 1 month was 16.2%. CONCLUSION: Approximately, 70% of the RRS activations occurred within postoperative day 3. Circulatory problems were a more frequent cause of RRS activation in the postoperative group than in the non-postoperative group. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00540-021-02900-4. Springer Singapore 2021-02-01 2021 /pmc/articles/PMC7969491/ /pubmed/33523292 http://dx.doi.org/10.1007/s00540-021-02900-4 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Original Article Sento, Yoshiki Arai, Masayasu Yamamori, Yuji Fujiwara, Shinsuke Tamashiro, Masahiro Kawamoto, Eiji Naito, Takaki Atagi, Kazuaki Fujitani, Shigeki Osaga, Satoshi Sobue, Kazuya The characteristics, types of intervention, and outcomes of postoperative patients who required rapid response system intervention: a nationwide database analysis |
title | The characteristics, types of intervention, and outcomes of postoperative patients who required rapid response system intervention: a nationwide database analysis |
title_full | The characteristics, types of intervention, and outcomes of postoperative patients who required rapid response system intervention: a nationwide database analysis |
title_fullStr | The characteristics, types of intervention, and outcomes of postoperative patients who required rapid response system intervention: a nationwide database analysis |
title_full_unstemmed | The characteristics, types of intervention, and outcomes of postoperative patients who required rapid response system intervention: a nationwide database analysis |
title_short | The characteristics, types of intervention, and outcomes of postoperative patients who required rapid response system intervention: a nationwide database analysis |
title_sort | characteristics, types of intervention, and outcomes of postoperative patients who required rapid response system intervention: a nationwide database analysis |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7969491/ https://www.ncbi.nlm.nih.gov/pubmed/33523292 http://dx.doi.org/10.1007/s00540-021-02900-4 |
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