Rapid response team activation prior to in-hospital cardiac arrest : Areas for improvements based on a national cohort study

INTRODUCTION: Rapid response teams (RRTs) are designed to improve the "chain of prevention" of in-hospital cardiac arrest (IHCA). We studied the 30-day survival of patients reviewed by RRTs within 24 hours prior to IHCA, as compared to patients not reviewed by RRTs.METHODS: A nationwide cohort study based on the Swedish Registry of Cardiopulmonary Resuscitation, between January 1st, 2014, and December 31st, 2021. An explorative, hypothesis-generating additional in-depth data collection from medical records was performed in a small subgroup of general ward patients reviewed by RRTs.RESULTS: In all, 12,915 IHCA patients were included. RRT-reviewed patients (n=2,058) had a lower unadjusted 30-day survival (25% vs 33%, p<0.001), a propensity score based odds ratio for 30-day survival of 0.92 (95% confidence interval 0.90-0.94, p<0.001) and were more likely to have a respiratory cause of IHCA (22% vs 15%, p<0.001). In the subgroup (n=82), respiratory distress was the most common RRT trigger, and 24% of the RRT reviews were delayed. Patient transfer to a higher level of care was associated with a higher 30-day survival rate (20% vs 2%, p