Introduction of the medical emergency team (MET) system: a cluster-randomised controlled trial.

@article{citeulike:1611305, abstract = {BACKGROUND: Patients with cardiac arrests or who die in general wards have often received delayed or inadequate care. We investigated whether the medical emergency team (MET) system could reduce the incidence of cardiac arrests, unplanned admissions to intensive care units (ICU), and deaths. METHODS: We randomised 23 hospitals in Australia to continue functioning as usual (n=11) or to introduce a MET system (n=12). The primary outcome was the composite of cardiac arrest, unexpected death, or unplanned ICU admission during the 6-month study period after MET activation. Analysis was by intention to treat. FINDINGS: Introduction of the MET increased the overall calling incidence for an emergency team (3.1 vs 8.7 per 1000 admissions, p=0.0001). The MET was called to 30\% of patients who fulfilled the calling criteria and who were subsequently admitted to the ICU. During the study, we recorded similar incidence of the composite primary outcome in the control and MET hospitals (5.86 vs 5.31 per 1000 admissions, p=0.640), as well as of the individual secondary outcomes (cardiac arrests, 1.64 vs 1.31, p=0.736; unplanned ICU admissions, 4.68 vs 4.19, p=0.599; and unexpected deaths, 1.18 vs 1.06, p=0.752). A reduction in the rate of cardiac arrests (p=0.003) and unexpected deaths (p=0.01) was seen from baseline to the study period for both groups combined. INTERPRETATION: The MET system greatly increases emergency team calling, but does not substantially affect the incidence of cardiac arrest, unplanned ICU admissions, or unexpected death.}, author = {Hillman, K. and Chen, J. and Cretikos, M. and Bellomo, R. and Brown, D. and Doig, G. and Finfer, S. and Flabouris, A. and }, citeulike-article-id = {1611305}, doi = {http://dx.doi.org/10.1016/S0140-6736(05)66733-5}, issn = {1474-547X}, journal = {Lancet}, keywords = {icu, rapid\_response}, number = {9477}, pages = {2091--2097}, posted-at = {2007-09-01 02:17:22}, priority = {3}, title = {Introduction of the medical emergency team (MET) system: a cluster-randomised controlled trial.}, url = {http://dx.doi.org/10.1016/S0140-6736(05)66733-5}, volume = {365}, year = {2005} }

TY - JOUR ID - citeulike:1611305 L3 - citeulike-article-id:1611305 TI - Introduction of the medical emergency team (MET) system: a cluster-randomised controlled trial. JF - Lancet VL - 365 IS - 9477 SP - 2091 EP - 2097 SN - 1474-547X N2 - BACKGROUND: Patients with cardiac arrests or who die in general wards have often received delayed or inadequate care. We investigated whether the medical emergency team (MET) system could reduce the incidence of cardiac arrests, unplanned admissions to intensive care units (ICU), and deaths. METHODS: We randomised 23 hospitals in Australia to continue functioning as usual (n=11) or to introduce a MET system (n=12). The primary outcome was the composite of cardiac arrest, unexpected death, or unplanned ICU admission during the 6-month study period after MET activation. Analysis was by intention to treat. FINDINGS: Introduction of the MET increased the overall calling incidence for an emergency team (3.1 vs 8.7 per 1000 admissions, p=0.0001). The MET was called to 30% of patients who fulfilled the calling criteria and who were subsequently admitted to the ICU. During the study, we recorded similar incidence of the composite primary outcome in the control and MET hospitals (5.86 vs 5.31 per 1000 admissions, p=0.640), as well as of the individual secondary outcomes (cardiac arrests, 1.64 vs 1.31, p=0.736; unplanned ICU admissions, 4.68 vs 4.19, p=0.599; and unexpected deaths, 1.18 vs 1.06, p=0.752). A reduction in the rate of cardiac arrests (p=0.003) and unexpected deaths (p=0.01) was seen from baseline to the study period for both groups combined. INTERPRETATION: The MET system greatly increases emergency team calling, but does not substantially affect the incidence of cardiac arrest, unplanned ICU admissions, or unexpected death. KW - icu KW - rapid_response AU - Hillman, K AU - Chen, J AU - Cretikos, M AU - Bellomo, R AU - Brown, D AU - Doig, G AU - Finfer, S AU - Flabouris, A PY - 2005///4 UR - http://dx.doi.org/10.1016/S0140-6736(05)66733-5 ER -