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Characteristics of In-Hospital Patients with Congenital Heart Disease Requiring Rapid Response System Activations: A Japanese Database Study

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Congenital Heart Disease 2022年第1期17卷 31-43页

作者： Taiki Haga Tomoyuki Masuyama Yoshiro Hayashi Takahiro Atsumi Kenzo Ishii Shinsuke Fujiwara Department of Pediatric critical care Medicine Osaka City General HospitalOsaka534-0021Japan Department of Emergency and critical care Medicine Jichi Medical University Saitama Medical CenterSaitama330-8503Japan Department of Intensive care Medicine Kameda Medical CenterChiba296-8602Japan Department of Emergency Medicine Seirei Hamamatsu General HospitalShizuoka430-8558Japan Department of Anesthesiology Intensive Care UnitFukuyama City HospitalHiroshima721-8511Japan Department of Emergency Medicine NHO Ureshino Medical CenterSaga843-0393Japan

Objectives:This study aimed to study the characteristics of in-hospital deterioration in patients with congenital heart disease who required rapid response system activation and identify risk factors associated with 1-month ***:We retrospectively analysed data from a Japanese rapid response system registry with 35 participating *** included consecutive patients with congenital heart disease who required rapid response system activation between January 2014 and March *** regression analyses were performed to examine the associations between 1-month mortality and other patient-specific ***:Among 9,607 patients for whom the rapid response system was activated,only 82(0.9%)had congenital heart *** few patients with congenital heart disease were being treated at the cardiology and cardiovascular surgery departments(12.3%and 9.9%,respectively).Moreover,the incidences of rapid-response events after intensive care unit discharge or surgery were low(6.8% and 12.2%,respectively).The most common reason for rapid response system activation was respiratory dysfunction(desaturation:35.4%,tachypnoea:25.6%,and new dyspnoea:19.5%).Rapid response system interventions and intensive care unit transfers were required for 65.9% and 20.7%of patients,*** mortality rate was 1.2% at the end of the rapid response system intervention and 11.0% after 1 ***,decreased respiratory rate and decreased heart rate at rapid response system activation were associated with increased 1-month *** adjusted odds ratio was 1.10(95% confidence interval 1.02–1.19)and 1.02(95% confidence interval,1.00–1.04) for respiratory rate and heart rate,***:Rapid response systems were rarely activated after cardiac surgery and intensive care unit discharge,which were situations with a high risk of sudden deterioration in patients with congenital heart ***,encouraging the use of the rapid response sys

关键词： Heart defects congenital emergencies clinical deterioration hospital rapid response team critical care this

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