Using rapid response system trigger clusters to characterize patterns of clinical deterioration among hospitalized adult patients

Many rapid response system (RRS) events are activated using multiple triggers. However, the patterns in which multiple RRS triggers occur together to activate RRS events are unknown. The purpose of this study was to identify these patterns (RRS trigger clusters) and determine their association with...

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Bibliographic Details
Published in:Resuscitation 2024-01, Vol.194, p.110041-110041, Article 110041
Main Authors: Piasecki, Rebecca J., Hunt, Elizabeth A., Perrin, Nancy, Spaulding, Erin M., Winters, Bradford, Samuel, Laura, Davidson, Patricia M., Chandra Strobos, Nisha, Churpek, Matthew, Himmelfarb, Cheryl R.
Format: Article
Language:English
Subjects:
Hospital mortality
In-hospital cardiac arrest
Rapid response systems
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Summary:Many rapid response system (RRS) events are activated using multiple triggers. However, the patterns in which multiple RRS triggers occur together to activate RRS events are unknown. The purpose of this study was to identify these patterns (RRS trigger clusters) and determine their association with outcomes among hospitalized adult patients. RRS events among adult patients from January 2015 to December 2019 in the Get With The Guidelines- Resuscitation registry’s MET module were examined (n = 134,406). Cluster analysis methods were performed to identify RRS trigger clusters. Pearson’s chi-squared and ANOVA tests were used to examine differences in patient characteristics across RRS trigger clusters. Multilevel logistic regressions were used to examine the associations between RRS trigger clusters and outcomes. Six RRS trigger clusters were identified. Predominant RRS triggers for each cluster were: tachypnea, new onset difficulty in breathing, decreased oxygen saturation (Cluster 1); tachypnea, decreased oxygen saturation, staff concern (Cluster 2); respiratory depression, decreased oxygen saturation, mental status changes (Cluster 3); tachycardia, staff concern (Cluster 4); mental status changes (Cluster 5); hypotension, staff concern (Cluster 6). Significant differences in patient characteristics were observed across clusters. Patients in Clusters 3 and 6 had an increased likelihood of in-hospital cardiac arrest (p 
ISSN:0300-9572
1873-1570
1873-1570
DOI:10.1016/j.resuscitation.2023.110041