Epidemiology of medical emergency team calls in patients undergoing lung transplantation

Patients undergoing lung transplantation (LTx) are at risk of clinical deterioration during hospital ward care. The epidemiology of Medical Emergency Team (MET) calls in LTx patients and their association with patient outcomes are poorly described.

We aimed to (1) measure the frequency, timing, and characteristics of MET activations in patients undergoing LTx, (2) evaluate differences in demographics and outcomes between those who had a MET call vs those who didn't.

A retrospective cohort study of patients who received MET calls during their index admission for LTx at the Alfred Hospital between January 2016 and December 2021.

Amongst 535 patients undergoing LTx, MET activation occurred in 265 (49.5%), with 738 MET activations in total. The MET group had a median (IQR) of 2 (1-4) MET calls. Pre-LTx period accounted for 15% of the calls, with hypoxia being the most common trigger (49.5%). During the post-LTx period, tachycardia (28.5%) and hypotension (33.1%) were the most common triggers. Hospital length-of stay (LOS) was longer in the MET group (26 [19-41] vs 19 days [15-27], p < 0.001), and ICU readmission occurred more frequently (27.5 vs 2.2%, p < 0.001). Post LTx MET activation had no impact on 90-day mortality [Adj HR (95% CI): 1.41 (0.19-10.60); p = 0.74] or on long-term survival [Adj HR (95% CI): 1.09 (0.80-1.49); p = 0.59].

MET activation is common in patients undergoing LTx. Admissions with MET are associated with higher rates of ICU readmission and longer hospital LOS compared to the no MET group, without affecting survival outcomes.