Evidence map›Paper›PMID 34430036›Full record

ArticleAcute medicine & surgery

Prevalence and predictors of direct discharge home following hospitalization of patients with serious adverse events managed by the rapid response system in Japan: a multicenter, retrospective, observational study.

Takashi Hongo, Hiromichi Naito, Toshifumi Fujiwara, Takaki Naito, Yosuke Homma, Yoshihisa Fujimoto, Morooka Takaya, Yuji Yamamori, Taka-Aki Nakada, Tsuyoshi Nojima and 3 more

Open access · goldAbstract read
In one paragraph

Article in Acute medicine & surgery. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 40% of its field
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

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. 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

13 authors at 7 institutions in 1 country.

Takashi HongoEmergency Department Okayama Saiseikai General Hospital Okayama Japan.ORCID https://orcid.org/0000-0002-1655-2294
Hiromichi NaitoDepartment of Emergency, Critical Care, and Disaster Medicine Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan.ORCID https://orcid.org/0000-0002-7308-1716
Toshifumi FujiwaraEmergency Department Okayama Saiseikai General Hospital Okayama Japan.
Takaki NaitoDepartment of Emergency and Critical Care Medicine St. Marianna University School of Medicine Kanagawa Japan.ORCID https://orcid.org/0000-0001-8333-0141
Yosuke HommaDepartment of Emergency and Critical Care Medicine Tokyo Bay Urayasu Ichikawa Medical Center Chiba Japan.ORCID https://orcid.org/0000-0002-0473-9617
Yoshihisa FujimotoDepartment of Emergency and Critical Care Medicine Tokyo Bay Urayasu Ichikawa Medical Center Chiba Japan.
Morooka TakayaEmergency and Critical Care Medical Center Osaka City General Hospital Osaka Japan.
Yuji YamamoriDepartment of Emergency and Critical Care Medicine Shimane Prefectural Central Hospital Shimane Japan.
Taka-Aki NakadaDepartment of Emergency and Critical Care Medicine Chiba University Graduate School of Medicine Chiba Japan.ORCID https://orcid.org/0000-0002-4480-556X
Tsuyoshi NojimaDepartment of Emergency, Critical Care, and Disaster Medicine Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan.ORCID https://orcid.org/0000-0003-0768-0179
Atsunori NakaoDepartment of Emergency, Critical Care, and Disaster Medicine Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan.ORCID https://orcid.org/0000-0002-6818-2985
Shigeki FujitaniDepartment of Emergency and Critical Care Medicine St. Marianna University School of Medicine Kanagawa Japan.ORCID https://orcid.org/0000-0001-6327-682X
In‐Hospital Emergency Study Group
Okayama University · JPJuntendo University Urayasu Hospital · JPSt. Marianna University School of Medicine · JPChiba University · JPOkayama Saiseikai General Hospital · JPOsaka City General Hospital · JPShimane Prefectural Central Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimThe rapid response system (RRS) is an in-hospital medical safety system. To date, not much is known about patient disposition after RRS activation, especially discharge home. This study aimed to investigate the prevalence, characteristics, and outcomes of patients with adverse events who required RRS activation.

methodsRetrospective data from the In-Hospital Emergency Registry in Japan collected from April 2016 to November 2020 were eligible for our analysis. We divided patients into Home Discharge, Transfer, and Death groups. The primary outcome was the prevalence of direct discharge home, and independently associated factors were determined using multivariable logistic regression.

resultsWe enrolled 2,043 patients who met the inclusion criteria. The prevalence of discharge home was 45.7%; 934 patients were included in the Home Discharge group. Age (adjusted odds ratio [AOR] 0.96; 95% confidence interval [CI], 0.95-0.97), malignancy (AOR 0.69; 95% CI, 0.48-0.99), oxygen administration before RRS (AOR 0.49; 95% CI, 0.36-0.66), cerebral performance category score on admission (AOR 0.38; 95% CI, 0.26-0.56), do not attempt resuscitation order before RRS (AOR 0.17; 95% CI, 0.10-0.29), RRS call for respiratory failure (AOR 0.50; 95% CI, 0.34-0.72), RRS call for stroke (AOR 0.12; 95% CI, 0.03-0.37), and intubation (AOR 0.20; 95% CI, 0.12-0.34) were independently negative, and RRS call for anaphylaxis (AOR 15.3; 95% CI, 2.72-86.3) was positively associated with discharge home.

conclusionLess than half of the in-hospital patients under RRS activation could discharge home. Patients' conditions before RRS activation, disorders requiring RRS activation, and intubation were factors that affected direct discharge home.

Indexed as

discharge to homeDNARRRSserious adverse event

Identifiers

PMID34430036
PMCPMC8366722
OpenAlexW3194543359

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.