EVALUATING PATIENT HEALTH OUTCOMES IN ONCOLOGY PATIENTS TRANSFERRED TO CRITICAL CARE FOLLOWING PRE-MET ASSESSMENT AND MET CALL ACTIVATION

Background: Early recognition of clinical deterioration is essential in oncology patients because of the complex nature of cancer, treatment-related complications, and associated comorbidities. Hospitals utilize escalation pathways such as Pre-Medical Emergency Team (Pre-MET) assessments and Medical Emergency Team (MET) call activations to facilitate timely intervention and transfer to critical care. However, limited evidence exists regarding the comparative effectiveness of these pathways in oncology patients.
Aim: To evaluate and compare the effectiveness of Pre-MET assessment and MET call activation in improving health outcomes among oncology patients transferred to the Critical Care Unit (CCU). 
Methods: A retrospective comparative observational study was conducted at Apollo Cancer Centre, Teynampet. The study included 365 adult oncology patients transferred to the CCU between January 2024 and December 2024 through either Pre-MET assessment (n=195) or MET call activation (n=170). Clinical outcomes evaluated included mortality, CCU length of stay, requirement for mechanical ventilation, and 30-day readmission. Descriptive and inferential statistics, including Chi-square and Mann-Whitney U tests, were used for analysis with statistical significance set at p<0.05. 
Results: Among the 365 patients studied, the mean CCU length of stay was significantly higher in the pre-MET group (6.01 days) compared with the MET group (3.21 days) (p<0.001). Mechanical ventilation was required more frequently among Pre-MET patients (56.4%) than MET patients (40.6%), demonstrating a statistically significant association (p=0.004). Mortality rates were lower in the pre-MET group (35.4%) than the MET group (43.5%), but the difference was not statistically significant (p=0.138). Similarly, 30-day readmission rates were lower among Pre-MET patients (10.8%) compared with MET patients (13.5%), although the difference was not statistically significant (p=0.518). 
Conclusion: The Pre-MET pathway was associated with numerically lower mortality and readmission rates compared to MET activation, although these differences were not statistically significant. Significant differences were observed in CCU length of stay and mechanical ventilation requirements between the two escalation pathways. These findings highlight the importance of early deterioration recognition and emphasize the need for larger multicenter studies to further evaluate the impact of Pre-MET interventions on oncology patient outcomes.