{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T07:15:42Z","timestamp":1772090142075,"version":"3.50.1"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T00:00:00Z","timestamp":1629936000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T00:00:00Z","timestamp":1629936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003625","name":"ministry of health and welfare","doi-asserted-by":"publisher","award":["HI18C0599"],"award-info":[{"award-number":["HI18C0599"]}],"id":[{"id":"10.13039\/501100003625","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Respir Res"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Rapid response systems (RRSs) improve patients\u2019 safety, but the role of dedicated doctors within these systems remains controversial. We aimed to evaluate patient survival rates and differences in types of interventions performed depending on the presence of dedicated doctors in the RRS.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Patients managed by the RRSs of 9 centers in South Korea from January 1, 2016, through December 31, 2017, were included retrospectively. We used propensity score-matched analysis to balance patients according to the presence of dedicated doctors in the RRS. The primary outcome was in-hospital survival. The secondary outcomes were the incidence of interventions performed. A sensitivity analysis was performed with the subgroup of patients diagnosed with sepsis or septic shock.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>After propensity score matching, 2981 patients were included per group according to the presence of dedicated doctors in the RRS. The presence of the dedicated doctors was not associated with patients\u2019 overall likelihood of survival (hazard ratio for death 1.05, 95% confidence interval [CI] 0.93\u20121.20). Interventions, such as arterial line insertion (odds ratio [OR] 25.33, 95% CI 15.12\u201242.44) and kidney replacement therapy (OR 10.77, 95% CI 6.10\u201219.01), were more commonly performed for patients detected using RRS with dedicated doctors. The presence of dedicated doctors in the RRS was associated with better survival of patients with sepsis or septic shock (hazard ratio for death 0.62, 95% CI 0.39\u20120.98) and lower intensive care unit admission rates (OR 0.53, 95% CI 0.37\u20120.75).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The presence of dedicated doctors within the RRS was not associated with better survival in the overall population but with better survival and lower intensive care unit admission rates for patients with sepsis or septic shock.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12931-021-01824-7","type":"journal-article","created":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T16:03:01Z","timestamp":1629993781000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Relationship between the presence of dedicated doctors in rapid response systems and patient outcome: a multicenter retrospective cohort study"],"prefix":"10.1186","volume":"22","author":[{"given":"Hyung-Jun","family":"Kim","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyeongman","family":"Jeon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Byung Ju","family":"Kang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jong-Joon","family":"Ahn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sang-Bum","family":"Hong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong-Hyun","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae Young","family":"Moon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jung Soo","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jisoo","family":"Park","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae Hwa","family":"Cho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sang-Min","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7697-4272","authenticated-orcid":false,"given":"Yeon Joo","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,8,26]]},"reference":[{"issue":"2","key":"1824_CR1","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1056\/NEJMra0910926","volume":"365","author":"DA Jones","year":"2011","unstructured":"Jones DA, DeVita MA, Bellomo R. Rapid-response teams. N Engl J Med. 2011;365(2):139\u201346.","journal-title":"N Engl J Med"},{"issue":"2","key":"1824_CR2","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1097\/00003246-199402000-00014","volume":"22","author":"C Franklin","year":"1994","unstructured":"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. 1994;22(2):244\u20137.","journal-title":"Crit Care Med"},{"issue":"3","key":"1824_CR3","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1001\/jama.295.3.324","volume":"295","author":"DM Berwick","year":"2006","unstructured":"Berwick DM, Calkins DR, McCannon CJ, Hackbarth AD. The 100,000 lives campaign: setting a goal and a deadline for improving health care quality. JAMA. 2006;295(3):324\u20137.","journal-title":"JAMA"},{"issue":"6","key":"1824_CR4","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1002\/jhm.2554","volume":"11","author":"RS Solomon","year":"2016","unstructured":"Solomon RS, Corwin GS, Barclay DC, Quddusi SF, Dannenberg MD. Effectiveness of rapid response teams on rates of in-hospital cardiopulmonary arrest and mortality: a systematic review and meta-analysis. J Hosp Med. 2016;11(6):438\u201345.","journal-title":"J Hosp Med"},{"key":"1824_CR5","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1016\/j.resuscitation.2018.05.013","volume":"128","author":"PG Lyons","year":"2018","unstructured":"Lyons PG, Edelson DP, Churpek MM. Rapid response systems. Resuscitation. 2018;128:191\u20137.","journal-title":"Resuscitation"},{"issue":"6","key":"1824_CR6","doi-asserted-by":"publisher","first-page":"e592","DOI":"10.1097\/CCM.0000000000002314","volume":"45","author":"Y Kim","year":"2017","unstructured":"Kim Y, Lee DS, Min H, Choi YY, Lee EY, Song I, et al. Effectiveness analysis of a part-time rapid response system during operation versus nonoperation. Crit Care Med. 2017;45(6):e592\u20139.","journal-title":"Crit Care Med"},{"issue":"4","key":"1824_CR7","first-page":"186","volume":"41","author":"DP Stolldorf","year":"2015","unstructured":"Stolldorf DP, Jones CB. Deployment of rapid response teams by 31 hospitals in a statewide collaborative. Jt Comm J Qual Patient Saf. 2015;41(4):186\u201391.","journal-title":"Jt Comm J Qual Patient Saf"},{"issue":"2","key":"1824_CR8","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1161\/CIRCULATIONAHA.118.033674","volume":"138","author":"BK Nallamothu","year":"2018","unstructured":"Nallamothu BK, Guetterman TC, Harrod M, Kellenberg JE, Lehrich JL, Kronick SL, et al. How do resuscitation teams at top-performing hospitals for in-hospital cardiac arrest succeed? A qualitative study. Circulation. 2018;138(2):154\u201363.","journal-title":"Circulation"},{"issue":"6","key":"1824_CR9","doi-asserted-by":"publisher","first-page":"e007167","DOI":"10.1136\/bmjopen-2014-007167","volume":"5","author":"R Martin-Misener","year":"2015","unstructured":"Martin-Misener R, Harbman P, Donald F, Reid K, Kilpatrick K, Carter N, et al. Cost-effectiveness of nurse practitioners in primary and specialised ambulatory care: systematic review. BMJ Open. 2015;5(6):e007167.","journal-title":"BMJ Open."},{"issue":"1","key":"1824_CR10","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1186\/s13054-015-0973-y","volume":"19","author":"R Maharaj","year":"2015","unstructured":"Maharaj R, Raffaele I, Wendon J. Rapid response systems: a systematic review and meta-analysis. Crit Care. 2015;19(1):254.","journal-title":"Crit Care"},{"issue":"10","key":"1824_CR11","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1093\/qjmed\/94.10.521","volume":"94","author":"CP Subbe","year":"2001","unstructured":"Subbe CP, Kruger M, Rutherford P, Gemmel L. Validation of a modified Early Warning Score in medical admissions. QJM. 2001;94(10):521\u20136.","journal-title":"QJM"},{"issue":"1","key":"1824_CR12","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1093\/biomet\/70.1.41","volume":"70","author":"PR Rosenbaum","year":"1983","unstructured":"Rosenbaum PR, Rubin DB. The central role of the propensity score in observational studies for causal effects. Biometrika. 1983;70(1):41\u201355.","journal-title":"Biometrika"},{"issue":"3","key":"1824_CR13","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1080\/00273171.2011.568786","volume":"46","author":"PC Austin","year":"2011","unstructured":"Austin PC. An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivariate Behav Res. 2011;46(3):399\u2013424.","journal-title":"Multivariate Behav Res"},{"issue":"6","key":"1824_CR14","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1111\/j.1524-4733.2006.00130.x","volume":"9","author":"O Baser","year":"2006","unstructured":"Baser O. Too much ado about propensity score models? Comparing methods of propensity score matching. Value Health. 2006;9(6):377\u201385.","journal-title":"Value Health"},{"issue":"12","key":"1824_CR15","doi-asserted-by":"publisher","first-page":"2037","DOI":"10.1002\/sim.3150","volume":"27","author":"PC Austin","year":"2008","unstructured":"Austin PC. A critical appraisal of propensity-score matching in the medical literature between 1996 and 2003. Stat Med. 2008;27(12):2037\u201349.","journal-title":"Stat Med"},{"issue":"11","key":"1824_CR16","doi-asserted-by":"publisher","first-page":"1292","DOI":"10.1002\/sim.4200","volume":"30","author":"PC Austin","year":"2011","unstructured":"Austin PC. Comparing paired vs non-paired statistical methods of analyses when making inferences about absolute risk reductions in propensity-score matched samples. Stat Med. 2011;30(11):1292\u2013301.","journal-title":"Stat Med"},{"issue":"6","key":"1824_CR17","doi-asserted-by":"publisher","first-page":"925","DOI":"10.1007\/s00134-018-5085-0","volume":"44","author":"MM Levy","year":"2018","unstructured":"Levy MM, Evans LE, Rhodes A. The surviving sepsis campaign bundle: 2018 update. Intensive Care Med. 2018;44(6):925\u20138.","journal-title":"Intensive Care Med"},{"issue":"3","key":"1824_CR18","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1007\/s00134-017-4683-6","volume":"43","author":"A Rhodes","year":"2017","unstructured":"Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Intensive Care Med. 2017;43(3):304\u201377.","journal-title":"Intensive Care Med"},{"issue":"8","key":"1824_CR19","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1001\/jama.2016.0288","volume":"315","author":"CW Seymour","year":"2016","unstructured":"Seymour CW, Liu VX, Iwashyna TJ, Brunkhorst FM, Rea TD, Scherag A, et al. Assessment of clinical criteria for sepsis: for the third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315(8):762\u201374.","journal-title":"JAMA"},{"key":"1824_CR20","doi-asserted-by":"crossref","unstructured":"Zhang Z, Kim HJ, Lonjon G, Zhu Y, written on behalf of AMEB-DCTCG. Balance diagnostics after propensity score matching. Ann Transl Med. 2019;7(1):16.","DOI":"10.21037\/atm.2018.12.10"},{"issue":"8","key":"1824_CR21","doi-asserted-by":"publisher","first-page":"28","DOI":"10.18637\/jss.v042.i08","volume":"42","author":"DE Ho","year":"2011","unstructured":"Ho DE, Imai K, King G, Stuart EA. MatchIt: nonparametric preprocessing for parametric causal inference. J Stat Softw. 2011;42(8):28.","journal-title":"J Stat Softw"},{"issue":"12","key":"1824_CR22","doi-asserted-by":"publisher","first-page":"1434","DOI":"10.1016\/j.resuscitation.2012.07.017","volume":"83","author":"DS Morris","year":"2012","unstructured":"Morris DS, Schweickert W, Holena D, Handzel R, Sims C, Pascual JL, et al. Differences in outcomes between ICU attending and senior resident physician led medical emergency team responses. Resuscitation. 2012;83(12):1434\u20137.","journal-title":"Resuscitation"},{"issue":"2","key":"1824_CR23","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1136\/bmjqs-2011-000393","volume":"21","author":"CJ Karvellas","year":"2012","unstructured":"Karvellas CJ, de Souza IA, Gibney RT, Bagshaw SM. Association between implementation of an intensivist-led medical emergency team and mortality. BMJ Qual Saf. 2012;21(2):152\u20139.","journal-title":"BMJ Qual Saf"},{"key":"1824_CR24","doi-asserted-by":"publisher","DOI":"10.1177\/1751143720903234","author":"C Hall","year":"2020","unstructured":"Hall C, Samanta R, Trivedi M. Would your hospital benefit from a dedicated rapid response doctor? J Intensive Care Soc. 2020. https:\/\/doi.org\/10.1177\/1751143720903234.","journal-title":"J Intensive Care Soc."},{"issue":"4","key":"1824_CR25","doi-asserted-by":"publisher","first-page":"688","DOI":"10.3346\/jkms.2017.32.4.688","volume":"32","author":"YJ Lee","year":"2017","unstructured":"Lee YJ, Lee DS, Min H, Choi YY, Lee EY, Song I, et al. Differences in the clinical characteristics of rapid response system activation in patients admitted to medical or surgical services. J Korean Med Sci. 2017;32(4):688\u201394.","journal-title":"J Korean Med Sci"},{"issue":"20","key":"1824_CR26","doi-asserted-by":"publisher","first-page":"2099","DOI":"10.1001\/jama.2018.14282","volume":"320","author":"E Azoulay","year":"2018","unstructured":"Azoulay E, Lemiale V, Mokart D, Nseir S, Argaud L, Pene F, et al. Effect of high-flow nasal oxygen vs standard oxygen on 28-day mortality in immunocompromised patients with acute respiratory failure: the HIGH randomized clinical trial. JAMA. 2018;320(20):2099\u2013107.","journal-title":"JAMA"},{"issue":"9685","key":"1824_CR27","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1016\/S0140-6736(09)60496-7","volume":"374","author":"S Nava","year":"2009","unstructured":"Nava S, Hill N. Non-invasive ventilation in acute respiratory failure. Lancet. 2009;374(9685):250\u20139.","journal-title":"Lancet"},{"issue":"17","key":"1824_CR28","doi-asserted-by":"publisher","first-page":"1809","DOI":"10.1001\/jama.2013.280502","volume":"310","author":"D Annane","year":"2013","unstructured":"Annane D, Siami S, Jaber S, Martin C, Elatrous S, Declere AD, et al. Effects of fluid resuscitation with colloids vs crystalloids on mortality in critically ill patients presenting with hypovolemic shock: the CRISTAL randomized trial. JAMA. 2013;310(17):1809\u201317.","journal-title":"JAMA"},{"issue":"3","key":"1824_CR29","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1016\/j.mcna.2016.12.007","volume":"101","author":"M Suneja","year":"2017","unstructured":"Suneja M, Sanders ML. Hypertensive emergency. Med Clin North Am. 2017;101(3):465\u201378.","journal-title":"Med Clin North Am"},{"issue":"4","key":"1824_CR30","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1016\/j.resuscitation.2012.08.327","volume":"84","author":"DK Richardson","year":"2013","unstructured":"Richardson DK, Zive D, Daya M, Newgard CD. The impact of early do not resuscitate (DNR) orders on patient care and outcomes following resuscitation from out of hospital cardiac arrest. Resuscitation. 2013;84(4):483\u20137.","journal-title":"Resuscitation"},{"issue":"3","key":"1824_CR31","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1097\/CCM.0000000000002184","volume":"45","author":"DE Leisman","year":"2017","unstructured":"Leisman DE, Doerfler ME, Ward MF, Masick KD, Wie BJ, Gribben JL, et al. Survival benefit and cost savings from compliance with a simplified 3-hour sepsis bundle in a series of prospective, multisite, observational cohorts. Crit Care Med. 2017;45(3):395\u2013406.","journal-title":"Crit Care Med"},{"issue":"2","key":"1824_CR32","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1177\/0310057X1504300208","volume":"43","author":"G Cross","year":"2015","unstructured":"Cross G, Bilgrami I, Eastwood G, Johnson P, Howden BP, Bellomo R, et al. The epidemiology of sepsis during rapid response team reviews in a teaching hospital. Anaesth Intensive Care. 2015;43(2):193\u20138.","journal-title":"Anaesth Intensive Care"}],"container-title":["Respiratory Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12931-021-01824-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12931-021-01824-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12931-021-01824-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T16:04:10Z","timestamp":1629993850000},"score":1,"resource":{"primary":{"URL":"https:\/\/respiratory-research.biomedcentral.com\/articles\/10.1186\/s12931-021-01824-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,26]]},"references-count":32,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1824"],"URL":"https:\/\/doi.org\/10.1186\/s12931-021-01824-7","relation":{},"ISSN":["1465-993X"],"issn-type":[{"value":"1465-993X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,26]]},"assertion":[{"value":"14 June 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 August 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 August 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The development of this cohort was approved by the Institutional Review Board of each center. The need for informed consent was waived due to the observational nature of the study and use of anonymized data. Our study was conducted in accordance with the amended Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"236"}}