Evidence map›Paper›PMID 37952578›Full record

ArticleResuscitation2024

Using rapid response system trigger clusters to characterize patterns of clinical deterioration among hospitalized adult patients.

Rebecca J Piasecki, Elizabeth A Hunt, Nancy Perrin, Erin M Spaulding, Bradford Winters, Laura Samuel, Patricia M Davidson, Nisha Chandra Strobos, Matthew Churpek, Cheryl R Himmelfarb and 1 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Resuscitation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.3field-weighted citation impact, top 35% 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

0 citing papers in PubMed, 1 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 2 countries.

Rebecca J PiaseckiJohns Hopkins University, 3400 N. Charles St., Baltimore, MD 21218, United States. Electronic address: piasec15@msu.edu.
Elizabeth A HuntJohns Hopkins University, 3400 N. Charles St., Baltimore, MD 21218, United States.
Nancy PerrinJohns Hopkins University, 3400 N. Charles St., Baltimore, MD 21218, United States.
Erin M SpauldingJohns Hopkins University, 3400 N. Charles St., Baltimore, MD 21218, United States.
Bradford WintersJohns Hopkins University, 3400 N. Charles St., Baltimore, MD 21218, United States.
Laura SamuelJohns Hopkins University, 3400 N. Charles St., Baltimore, MD 21218, United States.
Patricia M DavidsonUniversity of Wollongong Australia, Northfields Ave., Wollongong, NSW 2522, Australia.
Nisha Chandra StrobosJohns Hopkins University, 3400 N. Charles St., Baltimore, MD 21218, United States.
Matthew ChurpekUniversity of Wisconsin-Madison, Union South, 1308 W. Dayton St., Madison, WI 53715, United States.
Cheryl R HimmelfarbJohns Hopkins University, 3400 N. Charles St., Baltimore, MD 21218, United States.
American Heart Association's Get With The Guidelines®-Resuscitation Investigators
Johns Hopkins University · USUniversity of Wisconsin–Madison · USUniversity of Wollongong · AU

Funding

CARDIOVASCULAR EPIDEMIOLOGY INSTITUTIONAL TRAININGT32HL007024 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI Elizabeth Selvin · 1985 to 2026
$17.5M
Interdisciplinary Training in Cardiovascular Health ResearchT32NR012704 · NINR · JOHNS HOPKINS UNIVERSITY · PI ALLEN, JERILYN K · 2011 to 2020
$1.8M
Medical emergency team trigger clusters: Describing symptom experience during clinical deterioration in the context of medical emergency team careF31NR018362 · NINR · JOHNS HOPKINS UNIVERSITY · PI PIASECKI, REBECCA J · 2019 to 2019
$45k
NHLBI NIH HHS T32 HL007024NINR NIH HHS F31 NR018362NINR NIH HHS T32 NR012704
6 · The paper itself

Abstract

backgroundMany rapid response system (RRS) events are activated using multiple triggers. However, the patterns in which multiple RRS triggers occur together to activate RRS events are unknown. The purpose of this study was to identify these patterns (RRS trigger clusters) and determine their association with outcomes among hospitalized adult patients.

methodsRRS events among adult patients from January 2015 to December 2019 in the Get With The Guidelines- Resuscitation registry's MET module were examined (n = 134,406). Cluster analysis methods were performed to identify RRS trigger clusters. Pearson's chi-squared and ANOVA tests were used to examine differences in patient characteristics across RRS trigger clusters. Multilevel logistic regressions were used to examine the associations between RRS trigger clusters and outcomes.

resultsSix RRS trigger clusters were identified. Predominant RRS triggers for each cluster were: tachypnea, new onset difficulty in breathing, decreased oxygen saturation (Cluster 1); tachypnea, decreased oxygen saturation, staff concern (Cluster 2); respiratory depression, decreased oxygen saturation, mental status changes (Cluster 3); tachycardia, staff concern (Cluster 4); mental status changes (Cluster 5); hypotension, staff concern (Cluster 6). Significant differences in patient characteristics were observed across clusters. Patients in Clusters 3 and 6 had an increased likelihood of in-hospital cardiac arrest (p < 0.01). All clusters had an increased risk of mortality (p < 0.01).

conclusionsWe discovered six novel RRS trigger clusters with differing relationships to adverse patient outcomes. RRS trigger clusters may prove crucial in clarifying the associations between RRS events and adverse outcomes and aiding in clinician decision-making during RRS events.

Indexed as

Clinical DeteriorationHospital Rapid Response TeamAdultHospital MortalityHumansIntensive Care UnitsTachypneaHospital mortalityIn-hospital cardiac arrestRapid response systems

Identifiers

PMID37952578
PMCPMC10842078
OpenAlexW4388563616

What OpenQuestion holds

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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.