Intern Med J. 2020 Oct 11. doi: 10.1111/imj.15093. Online ahead of print.
BACKGROUND: Medical emergency team (MET) calls allow unstable patients to be identified earlier and enables clinicians to institute timely management to ameliorate physiological stress. Sinus tachycardia is a common cause for triggering MET calls. In this study, outcome measures relating to patients who have a MET call for sinus tachycardia were analysed.
METHODS: Two hundred and ninety-three consecutive patients who had MET calls as a result of sinus tachycardia were included in the study. Outcome measures assessed included inpatient mortality, duration of hospital stay, change in disposition of patient care, change in goals of care, and underlying aetiology. Comparison between medical and procedural patients was also performed.
RESULTS: There were 154 patients in the medical group compared to 139 patients in the procedural group. Inpatient mortality was 13% and 6% respectively (p-value= 0.065). The duration of hospital stay was longer in the medical group (11 vs. 8 days, p-value= 0.295). Sepsis accounted for about 50% of MET call diagnoses in both groups. Around 20% of patients in both groups did not have a clear cause identified for the sinus tachycardia. About one-fifth of the patients in both groups were transferred to intensive care following the MET call (17% vs. 16%; p-value= 0.823).
CONCLUSIONS: Sinus tachycardia triggering MET call is not a benign condition. It not infrequently requires escalation of care and is associated with significant inpatient mortality. Clinicians should have a high index of suspicion for sepsis as the underlying cause. This article is protected by copyright. All rights reserved.
PMID:33040448 | DOI:10.1111/imj.15093