Medical emergency team involvement in patients hospitalized with acute myeloid leukemia

Abstract

Patients with acute myeloid leukemia (AML) are at risk for sudden clinical deterioration. We aimed to describe the incidence of medical emergency team (MET) activation, intensive care unit (ICU) admissions and outcomes for patients with AML. We performed a 5-year retrospective cohort study of patients hospitalized with AML. One hundred and seventy patients were divided into three groups: (1) MET activated (n = 34); (2) MET criteria present but MET not activated (n = 17); and (3) all other patients with AML (n = 119). MET activation incidence was 200 calls/1000 admissions (95% confidence interval [CI], 138–279), compared with a hospital-wide rate of 29.3 calls/1000 admissions (95% CI, 28.2–30.4) (relative risk 6.90; 95% CI, 4.77–9.67, p < 0.0001). Some 77% (n = 26) were triaged to the ICU. Hospital mortality was higher in MET activated and MET fulfilled without activation groups compared with all others (27% vs. 12% vs. 7%, p = 0.007). Changes to goals of care were more common with MET activation. Patients with AML commonly receive MET activation. Approximately one in 10 fulfill MET criteria, however do not receive MET activation.

Keywords::

• Acute myeloid leukemia
• medical emergency team
• rapid response team
• survival

Acknowledgements

Dr. Bagshaw is supported by a Canada Research Chair in Critical Care Nephrology and a Clinical Investigator Award from Alberta Innovates – Health Solutions.

Potential conflict of interest

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