Busy emergency departments 'offer best chance of survival'

Date: Jul-18-2014 An analysis of US hospitals finds that,

compared with the least busy, the busiest emergency departments give the best chance of surviving,

especially to patients whose condition is life-threatening.

In the journal Annals of Emergency Medicine, researchers from the University of Michigan

(U-M) Medical School report the first national, broad-based analysis of the link between the

volume of emergency patients that hospitals treat and the chance those patients will survive

their hospital stay.

They discovered that how many patients are admitted to an emergency department (ED) in a year

makes a difference to the chances of those patients surviving their stay - especially for the

sickest patients.

Overall, emergency patients had a 10% lower chance of dying if they went to one of the

busiest EDs than if they went to one of the least busy.

Chances of survival even greater for the sickest patients

The chance of survival was even greater for patients with life-threatening conditions. For

instance, the risk of dying with sepsis was 26% lower at the busiest compared with the least busy

EDs, even after taking a range of patient and hospital variables into account.

The study revealed that emergency patients had a 10% lower chance of dying if they went to one of the busiest EDs than if they went to one of the least busy.

For patients with lung failure, the chance of dying was 22% lower. The chances of dying

differed even for heart attack patients, note the researchers.

The data from the study, which covered 17.5 million patients attending nearly 3,000 hospitals

across the US, came from the Nationwide Inpatient Sample database compiled by the Agency for

Healthcare Research and Quality.

The researchers analyzed data on patients who had sought emergency care between 2005 and 2009.

They did not include patients transferred to another hospital or emergency department, those

admitted to observation units, and those attending hospitals that saw fewer than 1,000 emergency

patients in a year.

For their analysis, they looked at deaths occurring during the first 2 days of hospitalization

and during the whole stay.

Lead author Keith Kocher, assistant professor in Emergency Medicine and an emergency physician

with U-M Health System, warns that it is too early, based on these findings, to say that patients

and first responders should change which hospital to go to in an emergency:

"But the bottom line is that emergency departments and hospitals perform differently, there

really are differences in care and they matter."

24,000 fewer deaths per year if all EDs performed as well as the busiest

He and his colleagues estimate that if all emergency patients received the kind of treatment

delivered by the busiest EDs, 24,000 fewer patients would die each year.

The team did not look at why the differences in survival occur. That is for future studies to

probe.

However, Prof. Kocher says the take-home message is in an emergency, patients should still call

911 or go to the closest hospital because they do not know exactly what they are

experiencing.

"What makes one hospital better than another is still a black box, and emergency medicine is

still in its infancy in terms of figuring that out," he says.

The researchers say that with half of hospital patients now coming in through the ED, there is

value in sharing the lessons and data from the best-performing hospitals.

In February 2014, Medical News Today learned how a UK study suggested many more lives

would be saved if defibrillators were made as common as fire

extinguishers. Despite various attempts to raise awareness of their value, public access and

understanding of how to use defibrillators in the UK is still low, said the researchers.

Written by Catharine Paddock PhD

View all articles written by Catharine, or follow her on:

Courtesy: Medical News Today Note: Any medical information available in this news section is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional.