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Hospital rapid response team and patients with life-limiting illness: A multicentre retrospective cohort study

Sulistio, Merlina et al.

Palliative medicine. Volume 29:Number 4 (2015); pp 302-309 -- Sage

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  • Title:
    Hospital rapid response team and patients with life-limiting illness: A multicentre retrospective cohort study
  • Author: Sulistio, Merlina;
    Franco, Michael;
    Vo, Amanda;
    Poon, Peter;
    William, Leeroy;
    Bion, Julian;
    Coombs, Maureen
  • Found In: Palliative medicine. Volume 29:Number 4 (2015); pp 302-309
  • Journal Title: Palliative medicine
  • Subjects: Palliative Care--Periodicals; Cancer--Palliative treatment--Periodicals; Pain--Treatment--Periodicals; Palliatieve behandeling; Rapid response team--resuscitation orders--goals of care--end-of-life care--cardiac arrest--advance care planning; Dewey: 616.029
  • Rights: legaldeposit
  • Publication Details: Sage
  • Abstract: Background:

    Approximately one-third of rapid response team consultations involve issues of end-of-life care. We postulate a greater occurrence in patients with a life-limiting illness, in whom the opportunity for advance care planning and palliative care involvement should be offered.

    Aims:

    We aim to review the characteristics and compare outcomes of rapid response team consultations on patients with and without a life-limiting illness.

    Design/Setting:

    A 3-month retrospective cohort study of all rapid response team consultations was conducted. The sample population included all adult inpatients in a major teaching hospital network.

    Results:

    We identified 351 patients – including 139 with a life-limiting illness – receiving a total of 456 rapid response team consultations. The median time from admission to the first rapid response team consultation was 3 days. Patients with a life-limiting illness had a significantly higher mortality rate (41.7% vs 13.2%), were older (72.6 vs 63.5 years), more likely to come from a residential aged-care facility (29.5% vs 4.1%) and had a shorter hospital stay (10 vs 13 days). Rapid response team consultations resulted in a change to more palliative goals of care in 28.5% of patients, of whom two-thirds had a life-limiting illness.

    Conclusion:

    Patients with a life-limiting illness had worse outcomes post–rapid response team consultation. Our findings suggest that a routine clarification of goals of care for this cohort, within 3 days of hospital admission, may be advantageous. These discussions may provide clarity of purpose to treating teams, reduce the burden of unnecessary interventions and promote patient-centred care agreed upon in advance of any deterioration.


  • Identifier: System Number: LDEAvdc_100059889062.0x000001; Journal ISSN: 0269-2163; 10.1177/0269216314560802
  • Publication Date: 2015
  • Physical Description: Electronic
  • Shelfmark(s): ELD Digital store

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