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The deteriorating ward patient: a Swedish-Australian comparison
Gabriella Jäderling1, Paolo Calzavacca, Max Bell
1Department of Physiology and Pharmacology, Section for Anesthesiology and Intensive Care, Karolinska Institutet, 17176 Stockholm, Sweden. gabriella.jaderling@karolinska.se
Intensive Care Medicine
|March 4, 2011
Summary
Deteriorating ward patients show similar characteristics and outcomes across different healthcare systems. This suggests the challenge of managing these patients is universal, with high hospital mortality rates.
Area of Science:
- Critical Care Medicine
- Health Services Research
- International Health
Background:
- Rapid Response Teams (RRTs) are not widely adopted in Europe due to concerns about data relevance from other healthcare systems.
- This study addresses whether patient data for deteriorating patients differs between distinct healthcare systems.
Purpose of the Study:
- To compare patient characteristics and outcomes for deteriorating patients between two geographically and culturally distinct healthcare systems.
- To determine if the care of deteriorating ward patients is a global issue.
Main Methods:
- A comparative analysis of 3,063 Rapid Response Team (RRT) calls from Karolinska University Hospital (Sweden) and Austin Hospital (Australia).
- Demographic and clinical data, RRT triggers, and patient outcomes including 30-day mortality and Limitations of Medical Treatment (LOMT) orders were compared.
Main Results:
- Patient demographics (age, sex) and admission types (surgical/medical) were similar between the two hospitals.
- Respiratory issues were common triggers for RRT activation at both sites, with the 'worried' criterion frequently used.
- 30-day mortality rates (27.7% vs 29.4%) and Limitations of Medical Treatment (LOMT) order allocations (34.2% vs 30.8%) were comparable, with RRTs influencing LOMT in 14.4% vs 12.6% of cases.
Conclusions:
- Deteriorating ward patient characteristics, disposal, and outcomes are similar across geographically and culturally diverse healthcare systems.
- The management of deteriorating ward patients presents a global challenge in modern hospitals.
- Hospital mortality for deteriorating ward patients remains high.
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