Bellew et al evaluated early activation of the rapid response team for patients admitted from the Emergency Department. They reported a risk score to predict early rapid response team (PeRRT) activation. The authors are from the Mayo Clinic in Rochester.
Patient selection: patient admitted to a non-ICU bed from the ED
Early rapid response team activation was defined as within 12 hours of admission.
Parameters:
(1) diagnosis
(2) first respiratory rate in ED in breaths per minute
(3) last respiratory rate in ED in breaths per minute
(4) first oxygen saturation in ED in percent
(5) last oxygen saturation in ED in percent
(6) last heart rate in ED in beats per minute
(7) last systolic blood pressure in ED in mm Hg
Parameter |
Finding |
Points |
diagnosis |
infectious |
5 |
|
mental disorder |
3 |
|
respiratory disorder |
2 |
|
musculoskeletal disorder |
-3 |
|
other |
0 |
first respiratory rate |
< 24 |
0 |
|
>= 24 |
2 |
last respiratory rate |
< 23 |
0 |
|
>= 23 |
2 |
first oxygen saturation |
<= 92% |
3 |
|
> 92% |
0 |
last oxygen saturation |
<= 92% |
1 |
|
> 92% |
0 |
last heart rate |
< 106 |
0 |
|
>= 106 |
3 |
last systolic blood pressure |
<= 102 |
2 |
|
103-158 |
0 |
|
>= 159 |
2 |
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: -3
• maximum score: 18
• The higher the score the greater the probability of rapid response team activation.
Score |
Probability Activation |
< 0 |
5% |
0 |
7% |
1 |
9% |
2 |
12% |
3 |
16% |
4 |
21% |
5 |
27% |
6 |
34% |
7 |
42% |
8 |
50% |
9 |
58% |
10 |
65% |
>= 11 |
72% |
Performance:
• The area under the ROC curve is 0.76.