Effectiveness of rapid response teams in reducing intrahospital cardiac arrests and deaths: A systematic review and meta-analysis

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Abstract

Objective: To evaluate the effectiveness of rapid response teams using early identification of clinical deterioration in reducing the occurrence of in-hospital mortality and cardiorespiratory arrest. Data sources: The MEDLINE, LILACS, Cochrane Library, Center for Reviews and Dissemination databases were searched. Study selection: We included studies that evaluated the effectiveness of rapid response teams in adult hospital units, published in English, Portuguese, or Spanish, from 2000 to 2016; systematic reviews, clinical trials, cohort studies, and prepost ecological studies were eligible for inclusion. The quality of studies was independently assessed by two researchers using the Newcastle-Ottawa, modified Jadad, and Assessment of Multiple Systematic Reviews scales. Data extractions: The results were synthesized and tabulated. When risk measures were reported by the authors of the included studies, we estimated effectiveness as 1-RR or 1-OR. In prepost studies, we estimated effectiveness as the percent decrease in rates following the intervention. Results: Overall, 278 studies were identified, 256 of which were excluded after abstract evaluation, and two of which were excluded after full text evaluation. In the meta-analysis of the studies reporting mortality data, we calculated a risk ratio of 0.85 (95%CI 0.76 - 0.94); and for studies reporting cardiac arrest data the estimated risk ratio was 0.65 (95%CI 0.49 - 0.87). Evidence was assessed as low quality due to the high heterogeneity and risk of bias in primary studies. Conclusion: We conclude that rapid response teams may reduce inhospital mortality and cardiac arrests, although the quality of evidence for both outcomes is low.

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Rocha, H. A. L., De Castro Alcântara, A. C., Rocha, S. G. M. O., & Toscano, C. M. (2018). Effectiveness of rapid response teams in reducing intrahospital cardiac arrests and deaths: A systematic review and meta-analysis. Revista Brasileira de Terapia Intensiva. Associacao de Medicina Intensiva Brasileira - AMIB. https://doi.org/10.5935/0103-507X.20180049

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