Antecedents to and outcomes of medical emergency team calls in haematology patients

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BACKGROUND AND AIMS: Haematology inpatients are at high risk of acute deterioration. This study aimed to examine the frequency, characteristics and outcomes of medical emergency team (MET) activations in this population. METHODS: A retrospective cohort study was conducted of all haematology admissions to a tertiary hospital over 2 years. The primary outcome was the frequency of MET activation during an inpatient haematology admission. Secondary outcomes included identifying factors associated with MET calls and evaluating their relationship with in-hospital mortality. RESULTS: In the study period, there were 485 MET activations. Of the 1682 admissions in the study period, 278 admissions (17%) were complicated by MET activation. Of the 757 patients admitted in the study period, 223 patients (29%) had a MET activation. Acute myeloid leukaemia, higher Charlson Comorbidity Index scores and allogeneic stem cell transplantation were more common in patients who had a MET call. Nearly one-third of MET activations occurred within 48 h of admission. Common triggers were tachypnoea, tachycardia and hypotension. Intensive care unit (ICU) admission was more frequent with MET activation (24% vs. 3%, P < 0.001), as were longer median hospital stays (15.4 vs. 5.1 days, P < 0.001) and higher in-hospital mortality (14% vs. 1%, P < 0.001). Repeated MET calls increased the likelihood of ICU transfer. MET activation was strongly associated with in-hospital mortality (odds ratio, 37.87; 95% confidence interval, 10.98-130.58). CONCLUSIONS: MET activation occurs in nearly one in five haematology admissions and is associated with an increased risk of morbidity and mortality. Patients with acute myeloid leukaemia, high comorbidity or post-allogeneic transplant status are at the greatest risk, supporting the need for targeted monitoring and preventative strategies in this high-risk group.

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