Abstract
BackgroundPrevious studies have reported that the quality of cardiopulmonary resuscitation (CPR) is closely associated with patient outcomes. The aim of this study was to compare patient CPR outcomes across resident, emergency medicine, and rapid response teams.MethodsThe records of patients who underwent CPR at the Seoul National University Bundang Hospital from January 1, 2013 to December 31, 2016 were analyzed retrospectively. Return of spontaneous circulation, 10- and 30-day survival, and live discharge after return of spontaneous circulation were compared across patients treated by the three CPR teams.ResultsOf the 1145 CPR cases, 444 (39%) were conducted by the resident team, 431 (38%) by the rapid response team, and 270 (23%) by the emergency medicine team. The adjusted odds ratios for the return of spontaneous circulation and subsequent 10-day survival among patients who received CPR from the resident team compared to the rapid response team were 0.59 (P = 0.001) and 0.71 (P = 0.037), respectively. There were no significant differences in the 30-day survival and rate of live discharge between patients who received CPR from the rapid response and resident teams; likewise, no significant differences were observed between patients who received CPR from the emergency medicine and rapid response teams.ConclusionsPatients receiving CPR from the rapid response team may have higher 10-day survival and return of spontaneous circulation rates than those who receive CPR from the resident team. However, our results are limited by the differences in approach, time of CPR, and room settings between teams.
Highlights
Previous studies have reported that the quality of cardiopulmonary resuscitation (CPR) is closely associated with patient outcomes
The mean Charlson comorbidity scores did not significantly differ among patients treated by the three teams (RR team: 2.61 ± 1.32; resident team: 2.58 ± 1.06; emergency medicine (EM) team: 2.69 ± 1.35; P = 0.512)
return of spontaneous circulation (ROSC) rates, 10- and 30-day survival, and live discharge after ROSC The ROSC rate among patients treated by the rapid response (RR) team was 75% (324/431); this was significantly higher than that observed among the patients treated by the resident team (65%; 287/444) or the EM team (65%; 176/270) P = 0.001; (Fig. 1a)
Summary
Previous studies have reported that the quality of cardiopulmonary resuscitation (CPR) is closely associated with patient outcomes. The aim of this study was to compare patient CPR outcomes across resident, emergency medicine, and rapid response teams. Several studies have reported that having either a medical emergency team or a rapid response (RR) team designated for CPR could increase the quality of CPR [7, 8]. Most of these studies have been limited in that they compared patients “before” and “after” implementation of either RR or medical emergency team [7, 8]. Seoul National University Bundang Hospital (SNUBH) is a tertiary academic hospital that implemented a parttime RR team in October 2012 to conduct in-hospital CPR covering 47.6% of the week [9], while the on-call residents were responsible for the remaining 52.4% of
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