Tran et al reported predictors for mortality for a surgical patient who has had a rapid response team (RRT) activation. These can help to identify a patient who may benefit from more aggressive management. The authors are from multiple institutions in Canada and the United States.
Patient selection: surgical patient requiring rapid response team activation
Parameters:
(1) age in years
(2) admitting surgical service
(3) level of care designation
(4) reason for activation
(5) multiple RRT activations
(6) emergency surgery
(7) multiple operations
(8) ASA class
(9) Elixhauser comorbidity index score
Parameter
Finding
Adjusted Odds Ratio
age in years
< 65 years
1
>= 65 years
1.35
admitting service
general surgery
1.44
orthopedics
0.94
neurosurgery
2.09
trauma
1.62
vascular
1.71
other
1
level of care
ICU admission and CPR
1
ICU admission, no CPR
1.70
other
3.52
reason for activation
airway concerns
2.08
respiratory
1.95
arrhythmias
0.60
decreased level of consciousness
1.58
hypotension
1.28
other
1
multiple RRT
no
1
yes
2.01
emergency surgery
no
1
yes
2.04
multiple operations
no
1
yes
1.73
ASA class
1
1
2
1.39
3
1.93
4
2.69
5
3.73
Elixhauser comorbidity
0
1
1 to 19
1.89
>= 20
3.60
cumulative product of odds ratios for mortality =
= PRODUCT(all of the odds ratios)
Interpretation:
• minimum score: 1
• The higher the cumulative product the greater the risk of mortality.
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