Comparison of clinical outcomes between nurse practitioner and registrar-led medical emergency teams: a propensity-matched analysis
| العنوان: | Comparison of clinical outcomes between nurse practitioner and registrar-led medical emergency teams: a propensity-matched analysis |
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| المؤلفون: | Naomi Pratt, Gaby Bolton, Sachin Gupta, Jo Molloy, Ravindranath Tiruvoipati, Mayurathan Balachandran, Eldho Paul |
| المصدر: | Critical Care, Vol 25, Iss 1, Pp 1-10 (2021) Critical Care |
| بيانات النشر: | Springer Science and Business Media LLC, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Male, Nurse practitioners, media_common.quotation_subject, Critical Care and Intensive Care Medicine, Lower risk, MET call, 03 medical and health sciences, 0302 clinical medicine, Intensive care, Outcome Assessment, Health Care, Medical Staff, Hospital, medicine, Humans, Nurse Practitioners, 030212 general & internal medicine, Deterioration, Mortality, Propensity Score, Aged, Quality Indicators, Health Care, media_common, Aged, 80 and over, Patient Care Team, Selection bias, business.industry, Research, Incidence (epidemiology), Medical emergency team, Confounding, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 030208 emergency & critical care medicine, lcsh:RC86-88.9, Middle Aged, medicine.disease, Propensity score matching, Female, Discharge, Medical emergency, business |
| الوصف: | Objective Medical emergency teams (MET) are mostly led by physicians. Some hospitals are currently using nurse practitioners (NP) to lead MET calls. These are no studies comparing clinical outcomes between these two care models. To determine whether NP-led MET calls are associated with lower risk of acute patient deterioration, when compared to intensive care (ICU) registrar (ICUR)-led MET calls. Methods The composite primary outcome included recurrence of MET call, occurrence of code blue or ICU admission within 24 h. Secondary outcomes were mortality within 24 h of MET call, length of hospital stay, hospital mortality and proportion of patients discharged home. Propensity score matching was used to reduce selection bias from confounding factors between the ICUR and NP group. Results A total of 1343 MET calls were included (1070 NP, 273 ICUR led). On Univariable analysis, the incidence of the primary outcome was higher in ICUR-led MET calls (26.7% vs. 20.6%, p = 0.03). Of the secondary outcome measures, mortality within 24 h (3.4% vs. 7.7%, p = 0.002) and hospital mortality (12.7% vs. 20.5%, p = 0.001) were higher in ICUR-led MET calls. Propensity score-matched analysis of 263 pairs revealed the composite primary outcome was comparable between both groups, but NP-led group was associated with reduced risk of hospital mortality (OR 0.57, 95% CI 0.35–0.91, p = 0.02) and higher likelihood of discharge home (OR 1.55, 95% CI 1.09–2.2, p = 0.015). Conclusion Acute patient deterioration was comparable between ICUR- and NP-led MET calls. NP-led MET calls were associated with lower hospital mortality and higher likelihood of discharge home. |
| تدمد: | 1364-8535 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a69eaaa71fa620cacdf9973ed13596ea https://doi.org/10.1186/s13054-021-03534-4 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....a69eaaa71fa620cacdf9973ed13596ea |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 13648535 |
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