The analysis of unexpected death cases and emergency call system in one University Hospital
Hospitals are required to reduce unexpected inpatient death. In this retrospective study, we investigated patients who had died unexpectedly, and those who had received cardiopulmonary resuscitation (CPR) following a hospital emergency call (HEC) in our center within the previous year. The former an...
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| Published in | Japanese Journal of Reanimatology Vol. 33; no. 2; pp. 69 - 73 |
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| Main Authors | , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
The Japanese Society of Reanimatology
25.09.2014
日本蘇生学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0288-4348 1884-748X |
| DOI | 10.11414/jjreanimatology.33.69 |
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| Abstract | Hospitals are required to reduce unexpected inpatient death. In this retrospective study, we investigated patients who had died unexpectedly, and those who had received cardiopulmonary resuscitation (CPR) following a hospital emergency call (HEC) in our center within the previous year. The former and latter groups had 39 and 14 subjects, respectively, and approximately half of the total number of subjects had shown several signs of cardiopulmonary arrest (CPA). HEC had been requested infrequently for the former group, and those for whom HEC had not been requested showed a low rate of ROSC (return of spontaneous circulation). It was suggested that improvement in both the standards for requesting HEC and its administration may lead to an increase in the number of patients who can undergo intervention before developing CPA, and the ROSC rate. |
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| AbstractList | Hospitals are required to reduce unexpected inpatient death. In this retrospective study, we investigated patients who had died unexpectedly, and those who had received cardiopulmonary resuscitation (CPR) following a hospital emergency call (HEC) in our center within the previous year. The former and latter groups had 39 and 14 subjects, respectively, and approximately half of the total number of subjects had shown several signs of cardiopulmonary arrest (CPA). HEC had been requested infrequently for the former group, and those for whom HEC had not been requested showed a low rate of ROSC (return of spontaneous circulation). It was suggested that improvement in both the standards for requesting HEC and its administration may lead to an increase in the number of patients who can undergo intervention before developing CPA, and the ROSC rate.
院内患者の予期せぬ在院死亡を減少させることが，病院機能として求められている。今回，我々は１年間の予期せぬ在院死亡症例と当院の院内緊急コールで心肺蘇生（CPR：cardiopulmonary resuscitation）を行った症例について後ろ向きに調査した。予期せぬ在院死亡症例は39例，この他に院内緊急コールでCPRを行った症例は14例で，両者を合計すると約半数に心肺停止前の予兆があった。予期せぬ在院死亡症例の院内緊急コール要請頻度は低く，院内緊急コールされなかった症例の自己心拍再開率は低かった。院内緊急コール要請基準と運用の見直しにより，心肺停止前に介入できうる症例の増加と蘇生率向上の可能性が示唆された。 Hospitals are required to reduce unexpected inpatient death. In this retrospective study, we investigated patients who had died unexpectedly, and those who had received cardiopulmonary resuscitation (CPR) following a hospital emergency call (HEC) in our center within the previous year. The former and latter groups had 39 and 14 subjects, respectively, and approximately half of the total number of subjects had shown several signs of cardiopulmonary arrest (CPA). HEC had been requested infrequently for the former group, and those for whom HEC had not been requested showed a low rate of ROSC (return of spontaneous circulation). It was suggested that improvement in both the standards for requesting HEC and its administration may lead to an increase in the number of patients who can undergo intervention before developing CPA, and the ROSC rate. |
| Author | Sumikawa, Koji Araki, Hiroshi Cho, Sungsam Yamashita, Kazunori Nagatani, Atsuko |
| Author_FL | 山下 和範 趙 成三 荒木 寛 澄川 耕二 長谷 敦子 |
| Author_FL_xml | – sequence: 1 fullname: 荒木 寛 – sequence: 2 fullname: 趙 成三 – sequence: 3 fullname: 山下 和範 – sequence: 4 fullname: 長谷 敦子 – sequence: 5 fullname: 澄川 耕二 |
| Author_xml | – sequence: 1 fullname: Sumikawa, Koji organization: Saiseikai Nagasaki Hospital – sequence: 1 fullname: Araki, Hiroshi organization: Department of Anesthesiology, Nagasaki University Hospital – sequence: 1 fullname: Yamashita, Kazunori organization: Department of emergency and disaster medicine, Nagasaki University Hospital – sequence: 1 fullname: Nagatani, Atsuko organization: Department of emergency and disaster medicine, Nagasaki University Hospital – sequence: 1 fullname: Cho, Sungsam organization: Department of Anesthesiology, Nagasaki University Hospital |
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| References | 5) Schein RM, Hazday N, Pena M, et al：Clinical antecedents to in-hospital cardiopulmonary arrest. Chest 98：1388-1392, 1990 8) 中 敏夫，篠﨑正博，島 幸広，ほか：当院でのMET（Medical Emergency Team）システムの導入経験．医療の質・安全学会誌5：213-217，2010 9) Goldhill DR, McNarry AF：Physiological abnormalities in early warning scores are related to mortality in adult inpatients. Br J Anaesth 92：882-884, 2004 2) 児玉貴光，中川雅史，川本英嗣，ほか：Rapid Response Systemによる院内救急対応．日臨麻会誌33：333-342，2013 7) Ehlenback WJ, Barnato AE, Curtis JR, et al：Epidemiologic study of in-hospital cardiopulmonary resuscitation in the eldery. N Engl J Med 361：22-31, 2009 1) 中 敏夫：日本の院内急変対応の現状とこれから―円滑な導入には客観的基準がカギ．Lisa 18：660-665，2011 4) Franklin C, Mathew J：Developing strategies to prevent inhospital cardiac arrest：analyzing responses of physicians and nurses in the hours before the event. Crit Care Med 22：244-247, 1994 6) 小山照幸，武田 聡，笠井督雄，ほか：当院の院内救急システムの検討．蘇生26：123-128，2007 3) 川崎達也：小児METの導入と展望―小児特有の病態生理の深い理解が不可欠．Lisa 18：686-690，2011 |
| References_xml | – reference: 1) 中 敏夫：日本の院内急変対応の現状とこれから―円滑な導入には客観的基準がカギ．Lisa 18：660-665，2011 – reference: 3) 川崎達也：小児METの導入と展望―小児特有の病態生理の深い理解が不可欠．Lisa 18：686-690，2011 – reference: 6) 小山照幸，武田 聡，笠井督雄，ほか：当院の院内救急システムの検討．蘇生26：123-128，2007 – reference: 2) 児玉貴光，中川雅史，川本英嗣，ほか：Rapid Response Systemによる院内救急対応．日臨麻会誌33：333-342，2013 – reference: 8) 中 敏夫，篠﨑正博，島 幸広，ほか：当院でのMET（Medical Emergency Team）システムの導入経験．医療の質・安全学会誌5：213-217，2010 – reference: 9) Goldhill DR, McNarry AF：Physiological abnormalities in early warning scores are related to mortality in adult inpatients. Br J Anaesth 92：882-884, 2004 – reference: 7) Ehlenback WJ, Barnato AE, Curtis JR, et al：Epidemiologic study of in-hospital cardiopulmonary resuscitation in the eldery. N Engl J Med 361：22-31, 2009 – reference: 5) Schein RM, Hazday N, Pena M, et al：Clinical antecedents to in-hospital cardiopulmonary arrest. Chest 98：1388-1392, 1990 – reference: 4) Franklin C, Mathew J：Developing strategies to prevent inhospital cardiac arrest：analyzing responses of physicians and nurses in the hours before the event. Crit Care Med 22：244-247, 1994 |
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| SubjectTerms | Emergency in hospital Patient safety Rapid response system unexpected death 予期せぬ在院死亡 医療安全 院内急変 |
| Title | The analysis of unexpected death cases and emergency call system in one University Hospital |
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