1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
2Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
3Division of Trauma and Surgical Critical Care, Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
4St. Mary’s Advanced Life Support Team, Department of Nursing, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
Copyright © 2020 The Korean Society of Critical Care Medicine
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICT OF INTEREST No potential conflict of interest relevant to this article was reported.
AUTHOR CONTRIBUTIONS
Conceptualization: SCK. Data curation: JL, SWK. Formal analysis: WHB. Methodology: EYK. Project administration: JL. Visualization: MRH. Writing - original draft: JL. Writing - review & editing: WHB, SCK.
Variable | Survivor (n=97) | Non-survivora (n=41) | P-value |
---|---|---|---|
Male sex | 42 (43.3) | 14 (34.1) | 0.417 |
Age (yr) | 63.0 (55.0–72.0) | 62.0 (51.0–72.0) | 0.843 |
Chemotherapy in last 30 days | 35 (36.1) | 18 (43.9) | 0.502 |
Charlson comorbidity score | 7.0 (6.0–8.0) | 8.0 (6.0–9.0) | 0.067 |
APACHE II score | 14.0 (9.0–18.5) | 17.0 (13.0–22.0) | 0.018 |
MEWS | 6.0 (4.0–8.0) | 7.0 (5.5–9.0) | 0.004 |
Day between admission and RRT activation | 4.0 (2.0–13.0) | 9.0 (3.0–26.0) | 0.032 |
ICU transfer | 46 (47.4) | 29 (70.7) | 0.020 |
Status of malignancy | |||
First presentation | 28 (28.9) | 10 (24.4) | 0.742 |
Relapse/refractory | 44 (45.4) | 21 (51.2) | 0.657 |
Extensive disease | 38 (39.2) | 21 (51.2) | 0.263 |
Duration of malignancy | 13.0 (1.0–48.0) | 9.0 (2.0–32.0) | 0.707 |
Values are presented as number (%) or median (interquartile range).
APACHE: Acute Physiology and Chronic Health Evaluation; MEWS: Modified Early Warning Score; RRT: rapid response team; ICU: intensive care unit.
aPatients who had a preexisting do-not-resuscitate order or change in code status within 24 hours post RRT activation were excluded from analysis.
Patients who had a preexisting do-not-resuscitate order or a change in code status within 24 hours post RRT activation were excluded from analysis.
CI: confidence interval; APACHE: Acute Physiology and Chronic Health Evaluation; MEWS: Modified Early Warning Score; RRT: rapid response team; ICU: intensive care unit.
Criteria |
---|
Respiratory rate ≤8/min or ≥25/min |
O2 Saturation ≤90% for more than 5 minutes with prior oxygen therapy |
pH ≤7.3, PaCO2 ≥50 mm Hg, PaO2 ≤55 mm Hg, lactic acid ≥2.0 mM/L |
Stridor/accessory muscle use |
Systolic blood pressure ≤85 mm Hg with correlated symptoms or signs |
Heart rate ≤50/min or ≥130/min |
Acute chest pain |
Urine output ≤50/ml in 4 hours |
Sudden alteration of consciousness |
Unexplained agitation or anxiety |
Seizure |
Any serious concerns about overall deterioration |
Variable | Non-cancer patient (n=293) | Cancer patient (n=164) | P-value |
---|---|---|---|
Male sex | 142 (48.5) | 65 (39.6) | 0.085 |
Age (yr) | 72.0 (59.0–80.0) | 63.0 (54.5–72.0) | <0.001 |
Diabetes | 106 (36.2) | 38 (23.2) | 0.006 |
Renal failure | 61 (20.8) | 7 (4.3) | <0.001 |
Congestive heart failure | 57 (19.5) | 8 (4.9) | <0.001 |
History of myocardial infarction | 60 (20.5) | 10 (6.1) | <0.001 |
Cerebrovascular disease | 51 (17.4) | 14 (8.5) | 0.014 |
Peripheral vascular disease | 33 (11.3) | 9 (5.5) | 0.060 |
Moderate to severe liver disease | 10 (3.4) | 11 (6.7) | 0.167 |
Dementia | 35 (11.9) | 5 (3.0) | 0.002 |
Connective tissue disease | 20 (6.8) | 8 (4.9) | 0.529 |
Hemiplegia | 13 (4.4) | 2 (1.2) | 0.117 |
Charlson comorbidity score | 5.0 (3.0–6.0) | 7.0 (6.0–9.0) | <0.001 |
APACHE II score | 14.0 (9.0–17.0) | 16.0 (10.0–20.0) | 0.007 |
MEWS | 5.0 (4.0–7.0) | 7.0 (5.0–8.0) | <0.001 |
Variable | Non-cancer patient (n=293) | Cancer patient (n=164) | P-value |
---|---|---|---|
In-hospital mortality | 32 (10.9) | 65 (39.6) | <0.001 |
ICU transfer required | 120 (41.0) | 85 (51.8) | 0.032 |
In-hospital mortality if ICU transfer required | 21 (17.5) | 39 (45.9) | <0.001 |
Pre-existing do-not-resuscitate | 0 | 2 (1.2) | 0.248 |
Code status change within 24 hours after RRT | 4 (1.4) | 24 (14.6) | <0.001 |
Palliative care involvement after RRT | 1 (0.6) | 11 (10.6) | <0.001 |
Variable | Survivor (n=97) | Non-survivor |
P-value |
---|---|---|---|
Male sex | 42 (43.3) | 14 (34.1) | 0.417 |
Age (yr) | 63.0 (55.0–72.0) | 62.0 (51.0–72.0) | 0.843 |
Chemotherapy in last 30 days | 35 (36.1) | 18 (43.9) | 0.502 |
Charlson comorbidity score | 7.0 (6.0–8.0) | 8.0 (6.0–9.0) | 0.067 |
APACHE II score | 14.0 (9.0–18.5) | 17.0 (13.0–22.0) | 0.018 |
MEWS | 6.0 (4.0–8.0) | 7.0 (5.5–9.0) | 0.004 |
Day between admission and RRT activation | 4.0 (2.0–13.0) | 9.0 (3.0–26.0) | 0.032 |
ICU transfer | 46 (47.4) | 29 (70.7) | 0.020 |
Status of malignancy | |||
First presentation | 28 (28.9) | 10 (24.4) | 0.742 |
Relapse/refractory | 44 (45.4) | 21 (51.2) | 0.657 |
Extensive disease | 38 (39.2) | 21 (51.2) | 0.263 |
Duration of malignancy | 13.0 (1.0–48.0) | 9.0 (2.0–32.0) | 0.707 |
Variable | Adjusted odds ratio (95% CI) | P-value |
---|---|---|
Age (yr) | 0.98 (0.94–1.02) | 0.405 |
Chemotherapy in last 30 days | 0.69 (0.24–1.97) | 0.492 |
Charlson comorbidity score | 1.20 (0.92–1.55) | 0.175 |
APACHE II score | 1.08 (1.01–1.15) | 0.027 |
MEWS | 1.02 (0.82–1.27) | 0.838 |
Days between admission and RRT activation | 1.01 (1.00–1.03) | 0.166 |
ICU transfer required | 2.52 (1.04–6.11) | 0.040 |
Status of malignancy | ||
Relapse/refractory | 0.76 (0.24–2.47) | 0.653 |
Extensive disease | 1.92 (0.79–4.66) | 0.151 |
Duration of malignancy | 0.99 (0.97–1.00) | 0.135 |
RRT: rapid response team; PaCO2: partial pressure of carbon dioxide.
Values are presented as number (%) or median (interquartile range). APACHE: Acute Physiology and Chronic Health Evaluation; MEWS: Modified Early Warning Score.
Values are presented as number (%). ICU: intensive care unit; RRT: rapid response team.
Values are presented as number (%) or median (interquartile range). APACHE: Acute Physiology and Chronic Health Evaluation; MEWS: Modified Early Warning Score; RRT: rapid response team; ICU: intensive care unit. Patients who had a preexisting do-not-resuscitate order or change in code status within 24 hours post RRT activation were excluded from analysis.
Patients who had a preexisting do-not-resuscitate order or a change in code status within 24 hours post RRT activation were excluded from analysis. CI: confidence interval; APACHE: Acute Physiology and Chronic Health Evaluation; MEWS: Modified Early Warning Score; RRT: rapid response team; ICU: intensive care unit.