Introduction: Rapid response teams (RRT) improve early intervention and reduce unplanned ICU admissions in the general inpatient population. Despite the support of RRT, there are limited studies on their impact on inpatient neurological and neurosurgical populations. We performed a dedicated cohort study on the impact of RRT activations on this population. Methods: We extracted all RRT activations over a one-year period (9/1/23 – 8/30/24) in a single tertiary academic medical center from an administrative database. RRT activations from non-ICU, primary neurology and neurosurgery inpatient locations were identified. Information gathered on patient demographics, activation reason, repeated activations, and complications. C-square testing used to compare proportions (p value < 0. 05). Results: 1125 non-ICU RRT activation events were identified, with 180 (16%) from primary neurological and neurosurgical inpatient locations. Analysis of 80 (44%) unique RRT activation completed to date. Most common activation reasons were respiratory failure (n=28, 35%), hemodynamic changes (n=15, 19%), and neurologic changes (n=15, 19%). Complications include 8 (10%) airways, 5 (6%) cardiopulmonary arrests, and 4 (5%) deaths within 24 hours of activation. 12 patients experienced repeated RRT activations (average age 68 years, SD 15 years), whereas 48 had only one event (average age 65 years, SD 17 years). 3 patients who had repeated activations (25%) died within 24 hours of activation (2 of which were after goals-of-care discussions (GOC), 1 from bradycardia) versus 1 deaths (2%, after GOC) among single-activation patients (p = 3x10^-9). Conclusions: Repeated RRT activation in hospitalized, non-ICU neuro-patients is strongly associated with death within 24 hours of RRT activation compared to single-RRT-event patients. Primary etiologies for RRT activation in this population are respiratory failure, hemodynamic changes, and neurologic changes. Completed analysis will determine clinical predictors for repeated RRT activation in this population and identify potential interventions/prevention strategies.
Chen et al. (Sun,) studied this question.