Long term survival following a medical emergency team call at an Australian regional hospital

Abstract

OBJECTIVE: To investigate the long term survival of medical emergency team (MET) patients at an Australian regional hospital and describe associated patient and MET call characteristics. DESIGN: Retrospective cohort study. Data linkage to the statewide death registry was performed to allow for long term survival analysis, including multivariable Cox proportional hazards regression and production of Kaplan–Meier survival curves. SETTING: A large Australian regional hospital. PARTICIPANTS: Adult patients who received a MET call from 1 July 2012 to 3 March 2020. MAIN OUTCOME MEASURES: Survival to 30, 90 and 180 days; one year; and 5-years after index MET call. RESULTS: The study included 6499 eligible patients. The cohort median age was 71 years, and 52.4% of the patients were female. Surgical (39.6%) and medical (36.9%) patients comprised most of the cohort. Thirty-day survival was 86.5% one-year survival was 66.1%. Among patients aged < 75 years, factors independently associated with significantly higher long term mortality included age (hazard ratio [HR], 3.26 [95% CI, 2.63–4.06]; for patients aged 65–74 v 18–54 years), male sex (HR, 0.71 [95% CI, 0.61–0.83]; for females) and pre-existing limitation of medical therapy (HR, 2.76; 95% CI, 2.28–3.35). Among patients aged ≥ 75 years, factors independently associated with significantly higher long term mortality included age (HR, 1.46 [95% CI, 1.29–1.65]; for patients aged ≥ 85 years), male sex (HR, 0.74 [95% CI, 0.66–0.83]; for females), and altered MET criteria (HR, 1.33; 95% CI, 1.03–1.71). CONCLUSIONS: Long term survival probabilities of MET call patients are affected by factors including age, sex, and limitation of medical therapy status. These data may be useful for clinicians conducting end-of-life discussions with patients.