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High ward occupancy, bedspacing, and 60 day mortality for patients with myocardial infarction, stroke, and heart failure

Abstract

Abstract
Aims
To study the consequences of crowded wards among patients with cardiovascular disease.

Methods and results
This is a cohort study among 201 801 patients with 258 807 admissions who were acutely admitted for myocardial infarction (N = 107 895), stroke (N = 87 336), or heart failure (N = 63 576) to any Norwegian hospital between 2008 and 2016. The ward admitting most patients with the given clinical condition was considered a patient's home ward. We compared patients with the same condition admitted when home ward occupancy was different, at the same hospital and during comparable time periods. Occupancy was standardized such that a one-unit difference corresponded to the interquartile range in occupancy in the given month. One interquartile increase in home ward occupancy was associated with 7% higher odds of admission to an alternate ward [odds ratio (OR) 1.07, 95% confidence interval (CI) 1.09 to 1.11], and length of stay was shorter (−0.10 days, 95% CI −0.18 to −0.09). Patients with heart failure had 15% higher odds of admission to alternate wards (OR 1.15, 95% CI 1.08 to 1.23) and increased mortality [hazard ratio (HR) 1.08, 95% CI 1.03 to 1.15]. We found no apparent effect on mortality for patients with myocardial infarction (HR 0.99, 95% CI 0.94 to 1.05) or stroke (HR 1.00, 95% CI 0.96 to 1.05).

Conclusions
Patients with heart failure had higher risk of admission to alternate wards when home ward occupancy was high. These patients may be negatively affected by full wards.

Category

Academic article

Client

  • Research Council of Norway (RCN) / 295989
  • Research Council of Norway (RCN) / 256579

Language

English

Author(s)

  • Andreas Asheim
  • Sara Marie Nilsen
  • Stina Aam
  • Kjartan Sarheim Anthun
  • Fredrik Carlsen
  • Imre Janszky
  • Lars Johan Vatten
  • Johan Håkon Bjørngaard

Affiliation

  • Norwegian University of Science and Technology
  • St. Olavs Hospital, Trondheim University Hospital
  • SINTEF Digital
  • Nord University

Year

2022

Published in

ESC Heart Failure

ISSN

2055-5822

Publisher

John Wiley & Sons

Volume

9

Page(s)

1884 - 1890

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