Influence of medical emergency team call system on critically ill patients

Introduction

Many patients admitted to hospital develop early signs of instability (such as tachycardia, hypotension, hypoxemia, and so on) before a critical event occurs [1]. Often those patients are admitted to the ICU with significant delay after multiple organ failure has developed. Different systems of early detection of unstable patients have been designed, one of them called the medical emergency team (MET) call system. The efficacy of systems is still debated [2, 3]. Introducing this system in our university hospital was supposed to improve the mortality and length of ICU stay for patients admitted to the ICU through this system.

Methods

The MET was established in our hospital in June 2006. Two groups of patients admitted to the ICU during a 2-year period were compared (before the MET call system and after its introduction).

Results

The standard group of patients admitted to the ICU within a 6-month period before introducing the MET call system included 115 patients; male/female 76/39; APACHE II score 25 (18 to 31); age 63 (53 to 74) years; length of stay 4 (2 to 9) days; mortality 22.6%, and was compared with the group admitted through the MET system: 100 patients; male/female 58/42; APACHE II score 23 (21 to 29); age 69 (59 to 75) years; length of stay 5 (3 to 9) days; mortality 32%. Variables are expressed as the median (IQR). There were no statistically significant differences between groups calculated by the chi-square and Mann–Whitney U tests.

Conclusion

The mortality and length of ICU stay of patients admitted to the ICU by the standard system compared with those admitted through the MET call system were not different. Early detection of the critically ill patients in the university hospital is supposed to improve their management and outcome. According to our results, we cannot so far confirm this statement.