Characteristics and outcomes of patients with repeated rapid response team activations in a tertiary centre in singapore

SESSION TITLE: Critical Care Posters 17 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/11/2023 12:00 pm - 12:45 pm PURPOSE: Rapid Response Teams (RRTs) are now an increasingly established part of many healthcare institutions, and they bring critical care expertise to the bedside. With each activation, the RRTs aim to improve patient outcomes through timely intervention1,2. This study aims to compare the characteristics and outcomes of single versus repeated RRT activations. References 1. Maharaj R, Raffaele I, Wendon J. Rapid response systems: a systematic review and meta-analysis. Crit Care. 2015;19(1):254. 2. Solomon RS, Corwin GS, Barclay DC, Quddusi SF, Dannenberg MD. Effectiveness of rapid response teams on rates of in-hospital cardiopulmonary arrest and mortality: A systematic review and meta-analysis. J Hosp Med. 2016;11(6):438-445. METHODS: A prospective cohort study of 1055 patients who required RRT activations in Singapore General Hospital was conducted from February 2018 to June 2020. Patient characteristics including demographics, Eastern Cooperative Oncology Group (ECOG) performance status, comorbidities, National Early Warning Score (NEWS) at the time of activation were collected for analysis. We compared these characteristics and outcomes between patients with single versus repeat RRT activations, and analyzed factors associated with increased mortality. RESULTS: Eighty-five patients had two or more RRT activations during their hospital stay. Repeat RRT activations was associated with an increased hospital length of stay (median of 46days (Interquartile Range 35-76days) versus median of 17days (IQR 9-34days), p<0.001) and in-hospital mortality (55.3% versus 33.9%, p<0.001). Repeat RRT activations remained significantly associated with in-hospital mortality (adjusted odds ratio 3.05 (95% CI)), even after adjustment for other factors such as ECOG performance status, NEWS, Charlson comorbidity index, and malignancy. CONCLUSIONS: Repeat RRT activations in the same hospitalization was associated with increased in-hospital mortality. CLINICAL IMPLICATIONS: Physicians and outreach teams should consider closer monitoring, early intervention, or early evaluation of goals of care, in patients requiring repeat RRT activations. DISCLOSURES: No relevant relationships by Hui Zhong Chai No relevant relationships by Ken Junyang Goh No relevant relationships by Michelle Koh No relevant relationships by Lit Soo Ng No relevant relationships by Joanna Phone Ko No relevant relationships by Deshawn Chong Xuan Tan No relevant relationships by Qiao Li Tan No relevant relationships by Si Ling Young