Prevalence, treatment, and outcomes of sepsis during rapid response team calls: A systematic review and meta-analysis

IF 1.7 4区医学 Q3 CRITICAL CARE MEDICINE

Critical Care and Resuscitation Pub Date : 2026-03-01 Epub Date: 2026-02-25 DOI:10.1016/j.ccrj.2026.100172

Lionel Soh BSC(Hons), MBBS , Ryan Ruiyang Ling MBBS , Wei Ling Chua PhD , Joshua Junjie Aw FCFP(S) , Natalie Robertson MPH , Kundan Reddy Saripalli MMed IM , Deb Sharp MAdvNursPrac(NPrac-CriticalCare) , Sophia Zhao MD , Daryl Jones BSc(Hons), MBBS, FRACP, FCICM, MD, PhD , Ashwin Subramaniam MBBS, GChPOM, MMed, FRACP, FCICM, PhD

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引用次数: 0

Abstract

Introduction

Sepsis is a leading cause of morbidity and mortality in hospitalised patients. Rapid Response Teams (RRTs) review clinically deteriorating patients, including those with sepsis. However, the epidemiology of sepsis in RRT calls remains unclear. This systematic review synthesised evidence on the prevalence, treatment, and outcomes of sepsis during RRT calls.

Methods

Seven electronic databases (PubMed, Web of Science, Embase, CINAHL, Cochrane Library, Ovid MEDLINE, and Scopus) were searched for studies published from 1 January 2015 to 31 May 2024. All articles were independently screened and assessed for study quality using the Newcastle Ottawa Scale by two reviewers per article. The primary outcome was the prevalence of sepsis during RRT calls. Secondary outcomes included hospital mortality and length of hospitalisation. Data were pooled using random-effects meta-analyses.

Results

From 5632 studies screened, 26 studies encompassing 110,909 patients and 139,076 RRT events were included. The pooled mean age was 64.4 years (95%CI: 59.2–69.7) and 48.4 % (n = 51,720, 24 studies) were male. The pooled prevalence of sepsis among all RRT calls was 23.7 % (95%CI: 15.5 %–34.6 %), with no significant difference between studies including exclusively sepsis RRT calls and studies with all causes of RRT calls (32.7 % vs. 21.8 %; p = 0.16). Common sepsis-related RRT triggers included abnormal respiratory and heart rates. Overall hospital mortality was 12.9 % (95%CI: 7.3–21.7 %) and hospital length of stay was 18 days (95%CI: 13.9–22.1), both showing no significant differences between studies including exclusively sepsis RRT calls and studies with all causes of RRT calls. New or changes in antibiotics were initiated in 38.8 % of sepsis-related RRTs. Most patients remained on the ward, while 23.3 % were transferred to the ICU.

Conclusions

Sepsis is a trigger for a quarter of RRT calls, associated with substantial resource use and mortality in one eighth of patients. These findings support the need for standardised recognition protocols, escalation guidelines and prospective trials to optimise outcomes.

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快速反应小组呼叫期间败血症的流行、治疗和结果：一项系统回顾和荟萃分析。

简介：败血症是住院患者发病和死亡的主要原因。快速反应小组（RRTs）审查临床恶化的患者，包括脓毒症患者。然而，RRT呼叫中败血症的流行病学尚不清楚。本系统综述综合了RRT呼叫期间脓毒症的患病率、治疗和结果的证据。方法：检索2015年1月1日至2024年5月31日发表的7个电子数据库（PubMed、Web of Science、Embase、CINAHL、Cochrane Library、Ovid MEDLINE和Scopus）。所有文章均采用纽卡斯尔渥太华量表进行独立筛选和研究质量评估，每篇文章由两名评论者进行评估。主要结果是RRT呼叫期间脓毒症的患病率。次要结局包括住院死亡率和住院时间。采用随机效应荟萃分析汇总数据。结果：从筛选的5632项研究中，纳入了26项研究，包括110,909名患者和139,076个RRT事件。合并平均年龄为64.4岁（95%CI: 59.2-69.7）， 48.4% （n = 51,720, 24项研究）为男性。所有RRT呼叫中脓毒症的总患病率为23.7% (95%CI: 15.5% - 34.6%)，仅包括脓毒症RRT呼叫的研究与所有原因的RRT呼叫的研究之间无显著差异（32.7%对21.8%;p = 0.16）。常见的败血症相关RRT触发因素包括呼吸和心率异常。总体住院死亡率为12.9% (95%CI: 7.3- 21.7%)，住院时间为18天（95%CI: 13.9-22.1），均显示仅包括败血症RRT呼叫的研究与所有原因RRT呼叫的研究之间无显著差异。38.8%的败血症相关rrt患者开始使用新的或改变抗生素。大多数患者留在病房，而23.3%的患者转移到ICU。结论：脓毒症是四分之一的RRT呼叫的触发因素，与大量资源使用和八分之一患者的死亡率相关。这些发现支持需要标准化的识别协议、升级指南和前瞻性试验来优化结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Critical Care and Resuscitation CRITICAL CARE MEDICINE-

CiteScore

7.70

自引率

3.40%

发文量

审稿时长

>12 weeks

期刊介绍： ritical Care and Resuscitation (CC&R) is the official scientific journal of the College of Intensive Care Medicine (CICM). The Journal is a quarterly publication (ISSN 1441-2772) with original articles of scientific and clinical interest in the specialities of Critical Care, Intensive Care, Anaesthesia, Emergency Medicine and related disciplines. The Journal is received by all Fellows and trainees, along with an increasing number of subscribers from around the world. The CC&R Journal currently has an impact factor of 3.3, placing it in 8th position in world critical care journals and in first position in the world outside the USA and Europe.