Int J Qual Health Care. 2025 Sep 27:mzaf103. doi: 10.1093/intqhc/mzaf103. Online ahead of print.
ABSTRACT
BACKGROUND: Although paediatric Rapid Response System implementation is gradually increasing worldwide, the characteristics of paediatric Rapid Response Systems and factors associated with adverse outcomes remain underexplored. In this study, we aimed to investigate the characteristics of paediatric Rapid Response Systems and factors associated with adverse outcomes by analysing data from a multicentre Rapid Response System registry in Japan.
METHODS: This retrospective observational study included patients aged <18 years who required Rapid Response System activation across 35 hospitals between November 2017 and June 2022. We analysed demographic data, clinical triggers, interventions, and outcomes, including a primary composite outcome defined as intensive care unit transfer, cardiac arrest, or death following Rapid Response System activation. Logistic regression was used to explore associations between clinical outcomes and various predictors.
RESULTS: Data of 213 paediatric patients (median age, 47 months) were analysed. Most Rapid Response System activations, primarily initiated by nurses, were for respiratory issues and clinical concerns. Approximately 60% of activations involved interventions. Cardiac arrest, intensive care unit admission, and mortality following Rapid Response System activation occurred in 4.7%, 24.9%, and 1.9% of cases, respectively, resulting in a composite outcome rate of 28.6%. A decreased SpO2, lower blood pressure, increased body temperature, and altered consciousness at the time of Rapid Response System activation were significantly associated with adverse outcomes. Furthermore, multiple violations of the criteria for Rapid Response System activation and multiple interventions were significantly associated with these outcomes.
CONCLUSION: This study provides valuable insights into the characteristics of paediatric patients requiring Rapid Response System activation and factors associated with adverse outcomes, which can optimize paediatric Rapid Response System protocols, potentially improving paediatric patient safety.
PMID:41014021 | DOI:10.1093/intqhc/mzaf103
