Trigger team activation for acute patients. A cohort study at a level 1 university hospital in Denmark

Abstract Background While patients with major trauma, suspected ST-elevation myocardial infarction (STEMI) or stroke have implemented pathways for quick access to specialized trigger teams, other patients with time dependent diseases present with less obvious aetiology and have less documented pathways at arrival to the hospital. Aim To describe the number, diagnosis and prognosis of patients arriving to the trigger teams for trauma, suspected STEMI, suspected stroke, and Medical emergency patients (MEP) Method Retrospective cohort study of all patients who between November 2012 and September 2015 had either a trauma, STEMI, stroke or MEP trigger team activation at arrival to Odense University Hospital – a level 1 trauma centre, a direct referral centre for patients with suspected STEMI to the catheterization laboratory or stroke, and with a trigger team at emergency department arrival of MEP patients from the local area. Results There were 8,075 activations of a trigger team at hospital arrival, median 7.6 calls per day (range 1-18); 16.7% trauma, 28.3% STEMI, 19.7% stroke and 35.3% MEP calls. This corresponds to 161/100,000 person years (py) with trauma calls, 64/100,000 py STEMI calls, 72/100,000 py stroke calls and 340/100,000 py MEP calls. Patients from the different calls had a 30-day mortality of 12% (trauma), 8% (STEMI), 5% (stroke), and 25% (MEP). Whereas patients from trauma, STEMI and stroke calls were mainly discharged within a few ICD10 (International classification of diseases, version 10) main coding areas, patients from MEP calls had discharge diagnosis within many different ICD10 main coding areas. Conclusion Trauma, STEMI and stroke trigger teams are used at a daily base, treat a prehospitally well-defined patient population and have a relatively low 7-day mortality. Patients with MEP calls are more frequent, have a diverse aetiology and a higher mortality than patients in the other trigger teams.