Single Versus Multiple Rapid Responses: Do Patient Characteristics and Outcomes Differ?

Introduction: Rapid Response Teams are a hospital-based resource to respond to acutely deteriorating patients outside of the ICU setting. Frequent rapid response events (RRs) in individual patients are associated with increased ICU admission, length of stay, and mortality. This study aims to identify unique characteristics of patients with multiple RRs and to understand the outcomes of patients who have multiple events in the United States academic setting.


Methods: We conducted a 6-month retrospective chart review of RR events at a single tertiary academic medical center (March 1, 2024 – July 31, 2024). Data was extracted on demographics, ICU transfer, hospital and ICU length of stay (LOS), and in-hospital and 90-day mortality. Patients were divided into those with a single RR and those with multiple RRs. Chi-square tests were used to assess significance for categorical variables and two-sample t-tests were used for continuous variables. Statistical significance was set at a p value of 0.05.


Results: The 903 RRs identified during the study period involved 621 unique patients, including 442 single RR patients and 179 multiple RR patients. The average age was 64 in the single RR group and 62 in the multiple RR group (p=0.24). The single RR group was 49.4% female, and the multiple RR group was 52.6% female (p=0.47). Patients with multiple RRs were significantly more likely to have hematologic malignancy (p=0.02) and history of solid organ or stem cell transplant (p < 0.01). ICU transfer rate was similar between groups (p=0.98). Average ICU LOS was 8 days for single RR patients and 5 days for multiple RR patients (p=0.12). Average hospital LOS was 32 days for multiple RR patients and 20 days for single RR patients (p < 0.01). Patients experiencing multiple RRs had higher hospital (p=0.01) and 90-day (p < 0.01) mortality.


Conclusions: Multiple RRs represent a notable inpatient population that utilize significant hospital resources. Our study identified a connection between multiple RRs and discrete patient populations. Interestingly, despite similar rates of ICU transfer, patients with multiple RRs had increased hospital LOS and hospital and 90-day mortality. Further investigation into the connection between hematologic malignancies, transplant and multiple RRs will be explored in the future.