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Prevalence and sensitivity of MET-criteria in a Scandinavian University Hospital
Abstract
Objective To make a preliminary estimation of the workload for a medical emergency team (MET) in a Scandinavian University Hospital by recording prevalent physiological data on all adult patients and to see if the patients with deviating physiology (i.e. fulfilling the study criteria, in essence a set of simplified MET-criteria) had an elevated mortality. We also tested sensitivity and specificity by altering the cut-off levels of the calling criteria. Design Cross sectional prevalence study. Setting University hospital in the capital of Sweden. Patients Adult patients treated in the general wards of the hospital. Patients from psychiatric wards and intensive care units were excluded from the study. Interventions None. Measurements and main results 4.5% of the scored patients fulfilled the study criteria. These patients had a 30-day mortality of 25% (confidence interval 12.7-41.2) as compared to 3.5% (2.4-5) for the patients not fulfilling the study criteria. Extended criteria revealed 18 deaths within 30 days, 8 more deaths than the original study criteria. However, 123 patients - equalling 13.8% of the cohort (CI 11.6-16.2) - fulfilled these criteria as compared to the 40 patients fulfilling the original study criteria. Thus, the 30-day mortality of the patients with positive extended criteria totalled 14.6% (CI 8.9-22.1). Restricted criteria showed a mere 20 patients (2.2%; CI 1.4-3.5) and only 4 deaths, making 30-day mortality 20% (CI 5.7-43.7); thus, sensitivity was actually lower using restricted criteria. Conclusions Even these modified - and simplified - MET-criteria proved to be able to single out patients with elevated mortality as compared to the rest of the hospital population. Extending the criteria significantly lowered sensitivity and would extend the MET-workload enormously. Restricting the criteria led to missed mortalities where intervention could be beneficial. The results suggest that a routine use of simple physiological tests can be of help in the identification of patients at risk.
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Our findings contrast with a point-prevalence study from 2006 from one of the two sites at KUH, which excluded patients in the ICU and showed a prevalence of DNACPR decisions of 4%.
“Although not directly comparable, our findings contrast with a point-prevalence study from 2006 from one of the two sites at KUH, which excluded patients in the ICU and showed a prevalence of DNACPR decisions of 4%.17”
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“17 A contributing factor to this discrepancy might be increased use of DNACPR decisions over time.”
Background
Metadata
- Authors
- Bell, M. B., Konrad, D., Granath, F., Ekbom, A., & Martling, C.-R.
- Affiliations
- Karolinska University Hospital (SE)
- Corresponding author
- Bell, Max B.
- ORCID
- Bell, Max B.
- Venue
- Resuscitation
- Publisher
- Elsevier BV
- Published
- 2006-07
- Volume
- 70
- Issue
- 1
- Pages
- 66-73
- ISSN
- 0300-9572 (ISSN-L)
- OpenAlex
- W2057994063
- Cited by
- 130
- References
- 0
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 7 · 2023: 7 · 2022: 2 · 2021: 5 · 2020: 3 · 2019: 2 · 2018: 4 · 2017: 16 · 2016: 5 · 2015: 12 · 2014: 7 · 2013: 6 · 2012: 6
- FWCI
- 5.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Resuscitation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Pittsburgh
- Topics
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Health Sciences › Medicine › Emergency Medicine › Cardiac Arrest and Resuscitation
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
- Keywords
- medical emergency team, 30-day mortality, sensitivity and specificity, physiological monitoring, general ward patients, risk identification, cut-off values
- MeSH terms
- Workforce, Adult, Aged, Aged, 80 and over, Critical Care, Cross-Sectional Studies, Emergency Service, Hospital, Female, Hospitals, University, Humans, Intensive Care Units, Male, Middle Aged, Monitoring, Physiologic, Patient Care Team, Sensitivity and Specificity, Sweden, Workload, Critical Illness, Hospital Mortality
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