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Medicina crítica (Colegio Mexicano de Medicina Crítica)

versión impresa ISSN 2448-8909

Resumen

CENTENO SEQUEIRA, Mauricio Anselmo et al. Comparing rapid response scales: vital signs, CART, qSOFA and Super SIRS. Med. crít. (Col. Mex. Med. Crít.) [online]. 2018, vol.32, n.3, pp.131-135.  Epub 27-Mar-2020. ISSN 2448-8909.

Introduction:

Rapid response teams can decrease mortality and the number of cardiorespiratory events outside critical areas. There is risk of a suboptimal team or over activation. It is intended to find the most useful tool for the initial assessment of patients in a rapid response team, calculating the performance of certain tools to detect the requirement of transfer to an intensive care unit and mortality, as well as the evaluation of the cases of rescue failure.

Material and methods:

Retrospective, observational study in which every adult patient evaluated by the rapid response team and every rescue failure were included, capturing demographic variables, vital signs and outcome (transfer to the intensive care unit and mortality). Subsequently, qSOFA, CART and Super SIRS were calculated for every patient, along with the performance of such scales for the detection of transfer and mortality using ROC curves. Odds ratios for mortality and rescue failure were calculated; also, the general number needed to treat.

Results:

A total of 158 patients were included, 40 transfers to the intensive care unit (25.3%), 10 deaths (6.3%) and eight rescue failures (5.1%). The CART scale showed the highest performance in the detection of transfer and mortality (areas under the curve: 0.63 y 0.66, respectively, p < 0.05). A rescue failure increased the risk of mortality 61 times, and the number needed to treat was two.

Conclusion:

The CART scale is the most effective tool for the detection of high risk patients in our population; it is imperative to avoid rescue failure due to the high risk of mortality.

Palabras llave : Rapid response; scales; mortality.

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