Background:
MET calls facilitate early intervention in deteriorating patients; however, it is unclear whether MET calls benefit patients with advanced cancer and poor prognosis.
Aim:
We aimed to review the patient characteristics and clinical details of MET calls and subsequent patient outcomes.
Method:
MET call records for oncology inpatients during 2016 were audited. Demographics, cancer and treatment data, resuscitation status and subsequent discharge destination and treatment were reviewed.
Results:
76 patients had a total of 131 MET calls between them. Median age was 67, 51% male. Median length of stay was 12 days (range 1-52). 90% had metastatic disease; cancer subtypes included lymphoma (21%), lung (19%), colorectal (11%), breast (11%).
56% MET calls were after hours (6pm-6am and weekends). MET calls were alerted for one or more of; systolic blood pressure <90mmHg (31%), heart rate >130 (31%), respiratory rate >30 (24%), dyspnoea (11%), hypoxia (13%) and change in GCS (11%).
75% patients had consensus resuscitation form (CRP) pre-MET compared with 87% post-MET. All patients admitted to ICU had a pre-MET CRP.
7% of patients were transferred to ICU. 93% patients remained on the ward post-MET call. 39% had a second MET call, and of these, 50% had a third MET call.
47% of patients died in hospital or were transferred to palliative care. Patients discharged home had a 30 day mortality of 15% and a 90 day mortality of 31%. Patients transferred to ICU had 38% 90 day mortality. 50% of patients discharged home had further anticancer treatment within 90 days.
Conclusion:
Oncology patients with terminal malignancies have poor outcomes following MET calls. Overall prognosis should be a major consideration when determining resuscitation status and MET call criteria for individual patients. Further investigation into barriers and education of staff managing patients for completion of consensus resuscitation plan is warranted.