Evidence map›Paper›PMID 33295715›Full record

ArticleCanadian journal of surgery. Journal canadien de chirurgie2020

Predictors of mortality and cost among surgical patients requiring rapid response team activation.

Alexandre Tran, Shannon M Fernando, Daniel I McIsaac, Bram Rochwerg, Garrick Mok, Andrew J E Seely, Dalibor Kubelik, Kenji Inaba, Dennis Y Kim, Peter M Reardon and 4 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Canadian journal of surgery. Journal canadien de chirurgie, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Preoperative sleep apnea screening protocol reduces medical emergency team activation in patients with atrial fibrillation.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024
    Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Alexandre TranFrom the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Seely, Kubelik); the Division of Critical Care Medicine, Department of Medicine, University of Ottawa, Ottawa, Ont. (Fernando, Seely, Kubelik, Reardon, Kyeremanteng); the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, McIsaac, Seely, Shen, Tanuseputro, Thavorn, Kyeremanteng); the Department of Emergency Medicine, University of Ottawa, Ottawa, Ont. (Fernando, Mok, Reardon); the Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ont. (McIsaac); the School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ont. (McIsaac, Seely, Tanuseputro, Thavorn); the Department of Medicine, Division of Critical Care, McMaster University, Hamilton, Ont. (Rochwerg); the Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ont. (Rochwerg); the Division of Acute Care Surgery, Department of Surgery, University of Southern California, Los Angeles, Calif. (Inaba); the Department of Surgery, University of California, Los Angeles, Calif. (Kim); the Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, Ont. (Tanuseputro, Kyeremanteng); and the Institut du Savoir Montfort, Ottawa, Ont. (Kyeremanteng).
Shannon M FernandoFrom the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Seely, Kubelik); the Division of Critical Care Medicine, Department of Medicine, University of Ottawa, Ottawa, Ont. (Fernando, Seely, Kubelik, Reardon, Kyeremanteng); the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, McIsaac, Seely, Shen, Tanuseputro, Thavorn, Kyeremanteng); the Department of Emergency Medicine, University of Ottawa, Ottawa, Ont. (Fernando, Mok, Reardon); the Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ont. (McIsaac); the School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ont. (McIsaac, Seely, Tanuseputro, Thavorn); the Department of Medicine, Division of Critical Care, McMaster University, Hamilton, Ont. (Rochwerg); the Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ont. (Rochwerg); the Division of Acute Care Surgery, Department of Surgery, University of Southern California, Los Angeles, Calif. (Inaba); the Department of Surgery, University of California, Los Angeles, Calif. (Kim); the Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, Ont. (Tanuseputro, Kyeremanteng); and the Institut du Savoir Montfort, Ottawa, Ont. (Kyeremanteng).
Daniel I McIsaacFrom the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Seely, Kubelik); the Division of Critical Care Medicine, Department of Medicine, University of Ottawa, Ottawa, Ont. (Fernando, Seely, Kubelik, Reardon, Kyeremanteng); the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, McIsaac, Seely, Shen, Tanuseputro, Thavorn, Kyeremanteng); the Department of Emergency Medicine, University of Ottawa, Ottawa, Ont. (Fernando, Mok, Reardon); the Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ont. (McIsaac); the School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ont. (McIsaac, Seely, Tanuseputro, Thavorn); the Department of Medicine, Division of Critical Care, McMaster University, Hamilton, Ont. (Rochwerg); the Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ont. (Rochwerg); the Division of Acute Care Surgery, Department of Surgery, University of Southern California, Los Angeles, Calif. (Inaba); the Department of Surgery, University of California, Los Angeles, Calif. (Kim); the Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, Ont. (Tanuseputro, Kyeremanteng); and the Institut du Savoir Montfort, Ottawa, Ont. (Kyeremanteng).
Bram RochwergFrom the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Seely, Kubelik); the Division of Critical Care Medicine, Department of Medicine, University of Ottawa, Ottawa, Ont. (Fernando, Seely, Kubelik, Reardon, Kyeremanteng); the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, McIsaac, Seely, Shen, Tanuseputro, Thavorn, Kyeremanteng); the Department of Emergency Medicine, University of Ottawa, Ottawa, Ont. (Fernando, Mok, Reardon); the Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ont. (McIsaac); the School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ont. (McIsaac, Seely, Tanuseputro, Thavorn); the Department of Medicine, Division of Critical Care, McMaster University, Hamilton, Ont. (Rochwerg); the Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ont. (Rochwerg); the Division of Acute Care Surgery, Department of Surgery, University of Southern California, Los Angeles, Calif. (Inaba); the Department of Surgery, University of California, Los Angeles, Calif. (Kim); the Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, Ont. (Tanuseputro, Kyeremanteng); and the Institut du Savoir Montfort, Ottawa, Ont. (Kyeremanteng).
Garrick MokFrom the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Seely, Kubelik); the Division of Critical Care Medicine, Department of Medicine, University of Ottawa, Ottawa, Ont. (Fernando, Seely, Kubelik, Reardon, Kyeremanteng); the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, McIsaac, Seely, Shen, Tanuseputro, Thavorn, Kyeremanteng); the Department of Emergency Medicine, University of Ottawa, Ottawa, Ont. (Fernando, Mok, Reardon); the Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ont. (McIsaac); the School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ont. (McIsaac, Seely, Tanuseputro, Thavorn); the Department of Medicine, Division of Critical Care, McMaster University, Hamilton, Ont. (Rochwerg); the Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ont. (Rochwerg); the Division of Acute Care Surgery, Department of Surgery, University of Southern California, Los Angeles, Calif. (Inaba); the Department of Surgery, University of California, Los Angeles, Calif. (Kim); the Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, Ont. (Tanuseputro, Kyeremanteng); and the Institut du Savoir Montfort, Ottawa, Ont. (Kyeremanteng).
Andrew J E SeelyFrom the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Seely, Kubelik); the Division of Critical Care Medicine, Department of Medicine, University of Ottawa, Ottawa, Ont. (Fernando, Seely, Kubelik, Reardon, Kyeremanteng); the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, McIsaac, Seely, Shen, Tanuseputro, Thavorn, Kyeremanteng); the Department of Emergency Medicine, University of Ottawa, Ottawa, Ont. (Fernando, Mok, Reardon); the Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ont. (McIsaac); the School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ont. (McIsaac, Seely, Tanuseputro, Thavorn); the Department of Medicine, Division of Critical Care, McMaster University, Hamilton, Ont. (Rochwerg); the Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ont. (Rochwerg); the Division of Acute Care Surgery, Department of Surgery, University of Southern California, Los Angeles, Calif. (Inaba); the Department of Surgery, University of California, Los Angeles, Calif. (Kim); the Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, Ont. (Tanuseputro, Kyeremanteng); and the Institut du Savoir Montfort, Ottawa, Ont. (Kyeremanteng).
Dalibor KubelikFrom the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Seely, Kubelik); the Division of Critical Care Medicine, Department of Medicine, University of Ottawa, Ottawa, Ont. (Fernando, Seely, Kubelik, Reardon, Kyeremanteng); the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, McIsaac, Seely, Shen, Tanuseputro, Thavorn, Kyeremanteng); the Department of Emergency Medicine, University of Ottawa, Ottawa, Ont. (Fernando, Mok, Reardon); the Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ont. (McIsaac); the School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ont. (McIsaac, Seely, Tanuseputro, Thavorn); the Department of Medicine, Division of Critical Care, McMaster University, Hamilton, Ont. (Rochwerg); the Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ont. (Rochwerg); the Division of Acute Care Surgery, Department of Surgery, University of Southern California, Los Angeles, Calif. (Inaba); the Department of Surgery, University of California, Los Angeles, Calif. (Kim); the Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, Ont. (Tanuseputro, Kyeremanteng); and the Institut du Savoir Montfort, Ottawa, Ont. (Kyeremanteng).
Kenji InabaFrom the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Seely, Kubelik); the Division of Critical Care Medicine, Department of Medicine, University of Ottawa, Ottawa, Ont. (Fernando, Seely, Kubelik, Reardon, Kyeremanteng); the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, McIsaac, Seely, Shen, Tanuseputro, Thavorn, Kyeremanteng); the Department of Emergency Medicine, University of Ottawa, Ottawa, Ont. (Fernando, Mok, Reardon); the Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ont. (McIsaac); the School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ont. (McIsaac, Seely, Tanuseputro, Thavorn); the Department of Medicine, Division of Critical Care, McMaster University, Hamilton, Ont. (Rochwerg); the Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ont. (Rochwerg); the Division of Acute Care Surgery, Department of Surgery, University of Southern California, Los Angeles, Calif. (Inaba); the Department of Surgery, University of California, Los Angeles, Calif. (Kim); the Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, Ont. (Tanuseputro, Kyeremanteng); and the Institut du Savoir Montfort, Ottawa, Ont. (Kyeremanteng).
Dennis Y KimFrom the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Seely, Kubelik); the Division of Critical Care Medicine, Department of Medicine, University of Ottawa, Ottawa, Ont. (Fernando, Seely, Kubelik, Reardon, Kyeremanteng); the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, McIsaac, Seely, Shen, Tanuseputro, Thavorn, Kyeremanteng); the Department of Emergency Medicine, University of Ottawa, Ottawa, Ont. (Fernando, Mok, Reardon); the Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ont. (McIsaac); the School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ont. (McIsaac, Seely, Tanuseputro, Thavorn); the Department of Medicine, Division of Critical Care, McMaster University, Hamilton, Ont. (Rochwerg); the Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ont. (Rochwerg); the Division of Acute Care Surgery, Department of Surgery, University of Southern California, Los Angeles, Calif. (Inaba); the Department of Surgery, University of California, Los Angeles, Calif. (Kim); the Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, Ont. (Tanuseputro, Kyeremanteng); and the Institut du Savoir Montfort, Ottawa, Ont. (Kyeremanteng).
Peter M ReardonFrom the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Seely, Kubelik); the Division of Critical Care Medicine, Department of Medicine, University of Ottawa, Ottawa, Ont. (Fernando, Seely, Kubelik, Reardon, Kyeremanteng); the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, McIsaac, Seely, Shen, Tanuseputro, Thavorn, Kyeremanteng); the Department of Emergency Medicine, University of Ottawa, Ottawa, Ont. (Fernando, Mok, Reardon); the Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ont. (McIsaac); the School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ont. (McIsaac, Seely, Tanuseputro, Thavorn); the Department of Medicine, Division of Critical Care, McMaster University, Hamilton, Ont. (Rochwerg); the Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ont. (Rochwerg); the Division of Acute Care Surgery, Department of Surgery, University of Southern California, Los Angeles, Calif. (Inaba); the Department of Surgery, University of California, Los Angeles, Calif. (Kim); the Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, Ont. (Tanuseputro, Kyeremanteng); and the Institut du Savoir Montfort, Ottawa, Ont. (Kyeremanteng).
Jennifer ShenFrom the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Seely, Kubelik); the Division of Critical Care Medicine, Department of Medicine, University of Ottawa, Ottawa, Ont. (Fernando, Seely, Kubelik, Reardon, Kyeremanteng); the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, McIsaac, Seely, Shen, Tanuseputro, Thavorn, Kyeremanteng); the Department of Emergency Medicine, University of Ottawa, Ottawa, Ont. (Fernando, Mok, Reardon); the Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ont. (McIsaac); the School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ont. (McIsaac, Seely, Tanuseputro, Thavorn); the Department of Medicine, Division of Critical Care, McMaster University, Hamilton, Ont. (Rochwerg); the Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ont. (Rochwerg); the Division of Acute Care Surgery, Department of Surgery, University of Southern California, Los Angeles, Calif. (Inaba); the Department of Surgery, University of California, Los Angeles, Calif. (Kim); the Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, Ont. (Tanuseputro, Kyeremanteng); and the Institut du Savoir Montfort, Ottawa, Ont. (Kyeremanteng).
Peter TanuseputroFrom the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Seely, Kubelik); the Division of Critical Care Medicine, Department of Medicine, University of Ottawa, Ottawa, Ont. (Fernando, Seely, Kubelik, Reardon, Kyeremanteng); the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, McIsaac, Seely, Shen, Tanuseputro, Thavorn, Kyeremanteng); the Department of Emergency Medicine, University of Ottawa, Ottawa, Ont. (Fernando, Mok, Reardon); the Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ont. (McIsaac); the School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ont. (McIsaac, Seely, Tanuseputro, Thavorn); the Department of Medicine, Division of Critical Care, McMaster University, Hamilton, Ont. (Rochwerg); the Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ont. (Rochwerg); the Division of Acute Care Surgery, Department of Surgery, University of Southern California, Los Angeles, Calif. (Inaba); the Department of Surgery, University of California, Los Angeles, Calif. (Kim); the Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, Ont. (Tanuseputro, Kyeremanteng); and the Institut du Savoir Montfort, Ottawa, Ont. (Kyeremanteng).
Kednapa ThavornFrom the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Seely, Kubelik); the Division of Critical Care Medicine, Department of Medicine, University of Ottawa, Ottawa, Ont. (Fernando, Seely, Kubelik, Reardon, Kyeremanteng); the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, McIsaac, Seely, Shen, Tanuseputro, Thavorn, Kyeremanteng); the Department of Emergency Medicine, University of Ottawa, Ottawa, Ont. (Fernando, Mok, Reardon); the Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ont. (McIsaac); the School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ont. (McIsaac, Seely, Tanuseputro, Thavorn); the Department of Medicine, Division of Critical Care, McMaster University, Hamilton, Ont. (Rochwerg); the Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ont. (Rochwerg); the Division of Acute Care Surgery, Department of Surgery, University of Southern California, Los Angeles, Calif. (Inaba); the Department of Surgery, University of California, Los Angeles, Calif. (Kim); the Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, Ont. (Tanuseputro, Kyeremanteng); and the Institut du Savoir Montfort, Ottawa, Ont. (Kyeremanteng).
Kwadwo KyeremantengFrom the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Seely, Kubelik); the Division of Critical Care Medicine, Department of Medicine, University of Ottawa, Ottawa, Ont. (Fernando, Seely, Kubelik, Reardon, Kyeremanteng); the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, McIsaac, Seely, Shen, Tanuseputro, Thavorn, Kyeremanteng); the Department of Emergency Medicine, University of Ottawa, Ottawa, Ont. (Fernando, Mok, Reardon); the Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ont. (McIsaac); the School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ont. (McIsaac, Seely, Tanuseputro, Thavorn); the Department of Medicine, Division of Critical Care, McMaster University, Hamilton, Ont. (Rochwerg); the Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ont. (Rochwerg); the Division of Acute Care Surgery, Department of Surgery, University of Southern California, Los Angeles, Calif. (Inaba); the Department of Surgery, University of California, Los Angeles, Calif. (Kim); the Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, Ont. (Tanuseputro, Kyeremanteng); and the Institut du Savoir Montfort, Ottawa, Ont. (Kyeremanteng).

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Prior studies of rapid response team (RRT) implementation for surgical patients have demonstrated mixed results with respect to reductions in poor outcomes. The aim of this study was to identify predictors of in-hospital mortality and hospital costs among surgical inpatients requiring RRT activation. Methods: We analyzed data prospectively collected from May 2012 to May 2016 at The Ottawa Hospital. We included patients who were at least 18 years of age, who were admitted to hospital, who received either preoperative or postoperative care, and and who required RRT activation. We created a multivariable logistic regression model to describe mortality predictors and a multivariable generalized linear model to describe cost predictors. Results: We included 1507 patients. The in-hospital mortality rate was 15.9%. The patient-related factors most strongly associated with mortality included an Elixhauser Comorbidity Index score of 20 or higher (odds ratio [OR] 3.60, 95% confidence interval [CI] 1.96-6.60) and care designations excluding admission to the intensive care unit and cardiopulmonary resuscitation (OR 3.52, 95% CI 2.25-5.52). The strongest surgical predictors included neurosurgical admission (OR 2.09, 95% CI 1.17-3.75), emergent surgery (OR 2.04, 95% CI 1.37-3.03) and occurrence of 2 or more operations (OR 1.73, 95% CI 1.21-2.46). Among RRT factors, occurrence of 2 or more RRT assessments (OR 2.01, 95% CI 1.44-2.80) conferred the highest mortality. Increased cost was strongly associated with admitting service, multiple surgeries, multiple RRT assessments and medical comorbidity. Conclusion: RRT activation among surgical inpatients identifies a population at high risk of death. We identified several predictors of mortality and cost, which represent opportunities for future quality improvement and patient safety initiatives.

Indexed as

Hospital MortalityAgedAged, 80 and overClinical DeteriorationComorbidityEmergency TreatmentFemaleHospital Rapid Response TeamHumansIntensive Care UnitsMaleMiddle AgedNeurosurgical ProceduresOntarioPatient SafetyPostoperative Complications

Identifiers

PMID33295715
PMCPMC7747835

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