Clinical outcome of medical emergency team activation according to trigger time

Medical emergency team (MET) activation is triggered either by direct call or electronic medical record (EMR)-based screening system, which is expected to detect at-risk patients for 24 hours a day. To compare clinical outcomes between daytime (from 7 am to 6 pm) and on-call time (from 6 pm to 7 am the next day), we analyzed a longitudinal cohort at an academic tertiary care hospital. From Jan 2009 to Dec 2016, 9736 patients were evaluated for ICU admission rate and 28-day mortality rate according to trigger time. During on-call time, 55.3% of cases were activated by screening rather than calling. Proportions of activation by screening were higher during on-call time, especially from midnight to 6 am than during the day-time (61.4% vs. 48.8%; p=0.007). Overall ICU admission rate was 28.9%; the on-call screening group had the lowest ICU admission rate (18.1%). Compared to the on-call screening group, the on-call calling group (35.9%; odds ratio (OR) 2.55; 95% CI 2.25-2.88; p In our current dual trigger system, screening is considered a useful supplementary system in detecting at-risk patients, especially during on-call time.