Do rapid response teams in hospitals improve patient survival?

January 01, 0001

Do rapid response teams in hospitals improve patient survival?

Rapid response teams (RRTs) increasingly have been adopted by hospitals. These US authors conducted a meta-analysis to assess the effect of RRTs on reducing cardiopulmonary arrest and hospital mortality rates. They included randomized clinical trials and prospective studies of RRTs that reported data on changes in the primary outcome of hospital mortality or the secondary outcome of cardiopulmonary arrest.

They found: “Eighteen studies from 17 publications (with 1 treated as 2 separate studies) were identified, involving nearly 1.3 million hospital admissions. Implementation of an RRT in adults was associated with a 33.8% reduction in rates of cardiopulmonary arrest outside the intensive care unit (ICU) (RR 0.66) but was not associated with lower hospital mortality rates (RR 0.96). In children, implementation of an RRT was associated with a 37.7% reduction in rates of cardiopulmonary arrest outside the ICU (RR 0.62) and a 21.4% reduction in hospital mortality rates (RR 0.79). The pooled mortality estimate in children, however, was not robust to sensitivity analyses. Moreover, studies frequently found evidence that deaths were prevented out of proportion to reductions in cases of cardiopulmonary arrest, raising questions about mechanisms of improvement.”

The authors concluded: ”Although RRTs have broad appeal, robust evidence to support their effectiveness in reducing hospital mortality is lacking.”

Here is an instance of a preventive service that is of uncertain benefit. Not all prevention makes a difference.

For the full abstract, click here.

Arch Intern Med 170(1):18-26, January 2010. © 2010 To the American Medical Association.
Rapid Response Teams-A Systematic Review and Meta-analysis. Paul S. Chan, Renuka Jain, Brahmajee K. Nallmothu, Robert A. Berg, Comilla Sasson. Correspondence to Dr. Chan:

Category HSR. Health Services Research. Keywords: rapid response teams, cardiopulmonary arrest, hospitals, mortality, meta-analysis
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 27 January 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.