RT Journal Article
SR Electronic
T1 Association between implementation of an intensivist-led medical emergency team and mortality
JF BMJ Quality & Safety
JO BMJ Qual Saf
FD BMJ Publishing Group Ltd
SP 152
OP 159
DO 10.1136/bmjqs-2011-000393
VO 21
IS 2
A1 Constantine J Karvellas
A1 Ivens A O de Souza
A1 R T Noel Gibney
A1 Sean M Bagshaw
YR 2012
UL http://qualitysafety.bmj.com/content/21/2/152.abstract
AB Purpose To evaluate the impact of implementation of a dedicated intensivist-led medical emergency team (IL-MET) on mortality in patients admitted to the intensive care unit (ICU).Methods All adult ward admissions to the ICU between July 2002 and December 2009 were reviewed (n=1920) after excluding readmissions and admissions for <24 h. IL-MET hours were defined as 8:00–15:59 (Monday to Friday). The following periods were analysed: period 1: 1 July 2002–31 August 2004 (control); period 2: 1 September 2004–11 February 2007 (partial MET without dedicated intensivist); and period 3: 12 February 2007–31 December 2009 (hospital-wide IL-MET).Results During all three periods, there were no significant differences in length of stay or mortality (IL-MET vs non-IL-MET hours, p>0.1 for all). On multivariate analysis, Acute Physiology and Chronic Health Evaluation (APACHE) II score and age were independently associated with mortality in all three periods (p<0.05 for all). During period 3, there was a non-significant trend towards decreased mortality if admitted during IL-MET hours (OR 0.73, 95% CI 0.51 to 1.03, p=0.08). During period 3, there was a non-significant trend towards decreased mortality if admitted during IL-MET hours (OR 0.73, 95% CI 0.51 to 1.03, p=0.08). However, this result likely reflects the observed increase in mortality during non-IL MET hours rather than improved mortality during IL-MET hours.Conclusion In a single centre experience, implementation of an IL-MET did not reduce the rate of in-hospital death or lengths of stay.