Características de la activación del código amarillo y factores relacionados a la ocurrencia de eventos adversos

Santos, Pollyana Karine Lopes dos; Oliveira, Gabriella Novelli; Sichieri, Karina; Cruz, Diná de Almeida Lopes Monteiro da; Nogueira, Lilia de Souza

Pollyana Karine Lopes dos Santos

contributed with the conception or design of the study

contributed with data analysis and/or interpretation

contributed to the final revision with critical and intellectual participation in the manuscript

Universidade de São Paulo. São Paulo, São Paulo, Brazil

https://orcid.org/0000-0002-6923-6519

Gabriella Novelli Oliveira Corresponding author: Gabriella Novelli Oliveira, novellioliveira@gmail.com

contributed with the conception or design of the study

contributed with data analysis and/or interpretation

contributed to the final revision with critical and intellectual participation in the manuscript

Universidade de São Paulo, Hospital Universitário. São Paulo, São Paulo, Brazil

https://orcid.org/0000-0003-2100-1937

Karina Sichieri

contributed with the conception or design of the study

contributed with data analysis and/or interpretation

contributed to the final revision with critical and intellectual participation in the manuscript

Universidade de São Paulo, Hospital Universitário. São Paulo, São Paulo, Brazil

https://orcid.org/0000-0002-5074-4636

Diná de Almeida Lopes Monteiro da Cruz

contributed with the conception or design of the study

contributed with data analysis and/or interpretation

contributed to the final revision with critical and intellectual participation in the manuscript

Universidade de São Paulo. São Paulo, São Paulo, Brazil

https://orcid.org/0000-0003-1373-409X

Lilia de Souza Nogueira

contributed with the conception or design of the study

contributed with data analysis and/or interpretation

contributed to the final revision with critical and intellectual participation in the manuscript

Universidade de São Paulo. São Paulo, São Paulo, Brazil

https://orcid.org/0000-0001-5387-3807

Corresponding author: Gabriella Novelli Oliveira, novellioliveira@gmail.com

EDITOR IN CHIEF: Antonio José de Almeida Filho

ASSOCIATE EDITOR: Renata Reis

Variables	n (%)	Average (SD^*)
Sex
Male	55 (60.4)
Female	36 (39.6)
Age		58.6 (19.5)
ICC score^†		2.7 (2.5)
Reason for hospitalization
Injury, poisoning and certain other consequences of external causes	34 (37.3)
Diseases of the digestive system	30 (33.0)
Neoplasms	8 (8.8)
Diseases of musculoskeletal system	5 (5.5)
Diseases of the respiratory system	5 (5.5)
Diseases of the skin and subcutaneous tissue	3 (3.3)
Diseases of the genitourinary system	2 (2.2)
Others^‡	4 (4.4)

Yellow Code trigger signals	n (%)^* * Allows more than one response; † Included dyspnea (n = 4), emesis (n = 2), low urinary output (n = 2), adventitious noises on pulmonary auscultation (n = 1), gastric reflux (n = 1), agitation (n = 1), anxiety (n = 1), distended abdomen (n = 1), occurrence with surgical wound (n = 1), respiratory failure (n = 1), occurrence with chest drain (n = 1), systolic pressure drop, but with a value greater than 90 mmHg (n = 1), pasty speech (n = 1), cold and sticky skin (n = 1) and intense sweating (n = 1).
Peripheral oxygen saturation < 90%	43 (40.2)
Systolic blood pressure < 90 mmHg	33 (30.8)
Chest pain	17 (15.9)
Acute change of mental state	17 (15.9)
Heart rate > 130 bpm	14 (13.1)
Respiratory rate > 28 breaths/minute	8 (7.5)
Systolic blood pressure > 180 mmHg	5 (4.7)
Significant acute bleeding	5 (4.7)
Heart rate < 40 bpm	4 (3.7)
Capillary glucose < 60 mg / dL	3 (2.8)
Respiratory rate < 8 breaths/minute	2 (1.9)
Capillary blood glucose > 400 mg / dL	1 (0.9)
Another trigger signal^†	20 (18.7)

Variables	Average	SD^{^*}	Median	Maximum	CI95%^†
Time between admission to the unit and the activation of the yellow code (in days)	5.2	7.5	2.1	38.8	4.0-6.9
Time between last vital sign measurement and yellow code activation (in hours)	4.9	3.6	4.0	15.0	4.2-5.6
Time between triggering the yellow code and the arrival of the RRT in the unit (in minutes)	12.9	24.3	10.0	175	9.5-19.7
Attendance time performed by RRT^‡ in unit (in minutes)	58.3	66.2	30.0	280.0	47.3-72.6

Proceedings conducted by RRT^{^*}	n (%)^†
Oxygen therapy/airway approach	49 (45.8)
Electrocardiogram exam	42 (39.3)
Laboratory tests	35 (32.7)
Volume expansion	35 (32.7)
Drug treatment/blood transfusion	35 (32.7)
Imaging examinations	30 (28.0)
Change of decubitus	5 (4.7)
Fasting	4 (3.7)
Device insertion	4 (3.7)
Other proceedings^‡	8 (7.5)

Variables	OR^{^* * OR - Odds Ratio;}	IC95%^† † CI - confidence interval;	Valor de p	VIF^‡ ‡ VIF - Variance Inflation Factor;
Male	0.654	0.177-2.386	0.516	1.444
Age	1.025	0.976-1.079	0.336	3.534
ICC score^§ § CCI - Charlson Comorbidity Index;	0.884	0.617-1.231	0.477	2.999
NEWS score^{\| \|}	1.005	0.608-1.622	0.985	1.613
Time between admission to the unit and activation of the code (in days)	0.869	0.708-0.990	0.098	1.444
Time between last vital sign measurement and code triggering (in hours)	0.909	0.673-1.216	0.521	3.710
Trigger signal
Respiratory rate < 8 breaths/minute	1.965	0.018-182.240	0.759	1.575
Respiratory rate > 28 breaths/minute	7.312	0.860-67.721	0.066	1.559
Systolic blood pressure < 90 mmHg	2.804	0.627-13.921	0.185	1.834
Systolic blood pressure > 180 mmHg	4.700	0.156-81.468	0.300	1.605
Heart rate < 40 bpm	8.084	0.439-147.890	0.141	1.593
Heart rate > 130 bpm	3.366	0.566-19.977	0.174	1.423
Peripheral oxygen saturation < 90%	1.679	0.468-6.044	0.421	1.408
Acute change of mental state	1.750	0.294-10.092	0.528	1.832
Significant acute bleeding	3.866	0.128-67.226	0.363	1.518
Chest pain	3.235	0.417-24.842	0.249	1.797
Capillary glucose < 60 mg / dL	3.205	0.079-93.780	0.495	1.820
Capillary blood glucose > 400 mg / dL	0.000	0.000-Inf	0.993	1.000
Another trigger signal	1.292	0.193-7.372	0.779	1.424
Time between code triggering and RRT^¶ ¶ RRT - Rapid Response Team. arrival in unit (in minutes)	1.000	0.975-1.023	0.981	1.315
RRT attendance time at the unit (in minutes)	1.012	1.003-1.023	0.014	1.610
Number of pipelines conducted by RRT \| \| NEWS - National Early Warning Score;	1.208	0.735-1.991	0.452	1.496

[1] Corresponding author: Gabriella Novelli Oliveira, novellioliveira@gmail.com

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Características de la activación del código amarillo y factores relacionados a la ocurrencia de eventos adversos

RESUMEN

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