Delayed Medical Emergency Team Calls and Associated Outcomes*

Abstract

OBJECTIVE: To determine whether there was an association between delayed medical emergency team calls and mortality after a medical emergency team review. DESIGN: This was a prospective observational study. SETTING: A university-affiliated tertiary referral hospital in Porto Alegre, Brazil. PATIENTS: All patients were reviewed by the medical emergency team from July 2008 to December 2009. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: There were 1,481 calls for 1,148 patients. Delayed medical emergency team calls occurred for 246 patients (21.4%). The criterion associated with delay was typically the same criterion for the subsequent medical emergency team call. Physicians had a greater prevalence of delayed medical emergency team calls (110 of 246 [44.7%]) than timely medical emergency team calls (267 of 902 [29.6%]; p < 0.001). The mortality at 30 days after medical emergency team review was higher among patients with delayed medical emergency team activation (152 [61.8%]) than patients receiving timely medical emergency team activation (378 [41.9%]; p < 0.001). In a multivariate analysis, delayed medical emergency team calls remained significantly associated with higher mortality. CONCLUSIONS: Delayed medical emergency team calls are common and are independently associated with higher mortality. This result reaffirms the concept and need for a rapid response system.