Document Detail


Combinations of early signs of critical illness predict in-hospital death-the SOCCER study (signs of critical conditions and emergency responses).
MedLine Citation:
PMID:  17069957     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Medical emergency team (MET) call criteria are late signs of a deteriorating clinical condition. Some early signs predict in-hospital death but have a high prevalence so their use as single sign call criteria could be wasteful of resources. This study searched a large database to explore the association of combinations of recordings of early signs (ES), or early with late signs (LS) with in-hospital death. METHODS: A cross-sectional survey was undertaken of 3046 non-do not attempt resuscitation adult admissions in 5 hospitals without MET over 14 days. The medical records were reviewed for recordings of 26 ES and 21 LS and in-hospital death. Combinations of ES with or without LS were examined as predictors of death. Global modified early warning scores (GMEWS) were calculated. FINDINGS: ES with LS, plus LS only, had higher odd ratios than ES alone. Four combinations of ES were strongly associated with death: cardiovascular plus respiratory with decrease in urinary output, cardiovascular plus respiratory with a decrease in consciousness, respiratory with decrease in urinary output, and cardiovascular plus respiratory. In other combinations, recordings of SpO2 90-95%, systolic blood pressure 80-100 mmHg or decrease in urinary output in turn occurring with one or more disturbed blood gas variable were associated with death. Compared with admissions whose GMEWS were 0-2, admissions with GMEWS 5-15 were 27.1 times more likely to die while those with GMEWS 3-4 were 6.5 times more likely. CONCLUSIONS: The results support the inclusion of early signs of a deteriorating clinical condition in sets of call criteria.
Authors:
Gordon A Harrison; Theresa Jacques; Mary-Louise McLaws; Gabrielle Kilborn
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2006-10-27
Journal Detail:
Title:  Resuscitation     Volume:  71     ISSN:  0300-9572     ISO Abbreviation:  Resuscitation     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-11-29     Completed Date:  2007-02-23     Revised Date:  2009-08-25    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  327-34     Citation Subset:  IM    
Affiliation:
Discipline of Anaesthetics, Intensive Care and Emergency Medicine, University of NSW, Sydney, Australia. dharrison@stvincents.com.au
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MeSH Terms
Descriptor/Qualifier:
Critical Care / organization & administration,  statistics & numerical data*
Critical Illness / mortality*
Critical Pathways / organization & administration*
Cross-Sectional Studies
Emergency Medical Services / organization & administration,  statistics & numerical data*
Health Care Surveys
Hospital Mortality / trends*
Humans
Medical Records / statistics & numerical data
New South Wales
Odds Ratio
Patient Admission / statistics & numerical data
Retrospective Studies
Severity of Illness Index*
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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