Internal medicine journal · 2025
Medical emergency team calls at end of life in a metropolitan teaching hospital: how preventable are they?
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Crosbie David, McCarthy Madeleine, Ghosh Angaj, Hayes Barbara, Suleiman Mani, Jones Daryl
Аннотация
BACKGROUND: A considerable proportion of medical emergency team (MET) calls involves dying patients. Little is known regarding the quality of care for these patients and whether MET involvement in a dying patient is preventable.
AIMS: To analyse a cohort of patient deaths at a metropolitan teaching hospital and compare the characteristics of those patients who received a MET review during their last admission with those who did not.
METHODS: A retrospective analysis was conducted of all deaths occurring on general wards during 2022. Patients admitted for palliative care or those cared for solely in the intensive care unit or emergency departments were excluded. Demographics, comorbidities, frailty scores and resuscitation status were ascertained. For the patients who had a MET call during their last admission the number and aetiology of calls, intensive care unit (ICU) admission and time between last MET review and death were also recorded.
RESULTS: Of 605 deaths, 567 (93.7%) fulfilled the inclusion criteria, of which 320 patients (56.3%) had a MET call. Patients receiving a MET call were less likely to have prior treatment limitations documented, and few were admitted to the ICU. Patients who received a MET call had a shorter time between treatment limitation and death.
CONCLUSIONS: Over half the patients who died on general wards had a MET call. These patients often had multiple reviews, and were less likely to have prior treatment limitations. Our study suggests that early review of treatment goals on admitted patients is warranted.
AIMS: To analyse a cohort of patient deaths at a metropolitan teaching hospital and compare the characteristics of those patients who received a MET review during their last admission with those who did not.
METHODS: A retrospective analysis was conducted of all deaths occurring on general wards during 2022. Patients admitted for palliative care or those cared for solely in the intensive care unit or emergency departments were excluded. Demographics, comorbidities, frailty scores and resuscitation status were ascertained. For the patients who had a MET call during their last admission the number and aetiology of calls, intensive care unit (ICU) admission and time between last MET review and death were also recorded.
RESULTS: Of 605 deaths, 567 (93.7%) fulfilled the inclusion criteria, of which 320 patients (56.3%) had a MET call. Patients receiving a MET call were less likely to have prior treatment limitations documented, and few were admitted to the ICU. Patients who received a MET call had a shorter time between treatment limitation and death.
CONCLUSIONS: Over half the patients who died on general wards had a MET call. These patients often had multiple reviews, and were less likely to have prior treatment limitations. Our study suggests that early review of treatment goals on admitted patients is warranted.