BACKGROUND: In this population-based cohort study involving a nationwide database from South Korea, we aimed to determine whether rapid response system (RRS) implementation is associated with mortality and morbidity after surgery under general anesthesia. METHODS: Patients who underwent surgery under general anesthesia at the hospital between January 1, 2021, and December 31, 2021. Patients admitted to hospitals with an RRS were categorized into the RRS group, whereas those without an RRS were categorized into the non-RRS group. The endpoints were 30-day mortality, 90-day mortality, and CPR performance in the event of cardiac arrest. RESULTS: A total of 1,416,844 patients who underwent surgery under general anesthesia were included. The RRS and non-RRS groups included 512,911 and 903,933 patients, respectively. After propensity score (PS) matching, 447,998 patients were included in both groups (223,999 patients per group). In the PS-matched cohort, compared with the non-RRS group, the RRS group had 7 % (odds ratio [OR]: 0.93, 95 % confidence interval [CI]: 0.89, 0.97
P = 0.002), 6 % (OR: 0.94, 95 % CI: 0.91, 0.97
P <
0.002), and 9 % (OR: 0.91, 95 % CI: 0.83, 0.98
P = 0.020) lower incidences of 30-day mortality, 90-day mortality, and CPR, respectively. CONCLUSIONS: The RRS group had lower 30-day and 90-day mortality rates than the non-RRS group after surgery under general anesthesia. Moreover, RRS was associated with a lower rate of CPR episodes resulting from cardiac arrest in patients undergoing general anesthesia after surgery.