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Abstract:
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Rapid-response-teams (RRT) were introduced to intervene early in the course of clinical deterioration and possibly prevent serious complications. We conducted a retrospective analysis using the Cleveland Clinic’s medical records from 3/1/2005 to 12/31/2018. We assess the association between introduction of the RRT in 2009 and in-hospital mortality using segmented regression in a GEE model. Baseline confounders were controlled for using IPTW. We assessed whether in-hospital mortality changed at the start of the intervention and whether the temporal trend differed from before to after initiation. A total of 628,533 hospitalizations were included in this analysis. Introduction of the RRT was associated with a slight initial increase in in-hospital mortality after start of the intervention accompanied by a reduction in slope (P=0.001), with post-intervention period odds of in-hospital mortality per additional year of 0.961, P< 0.001. In-hospital mortality decreased over time after the introduction of RRT. It remains unclear if these improvements were driven by the RRT or by overall improvement in health care over time.
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