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Critical Illness Events Linked to Worse Outcomes on Same Ward

Critical illness event tied to increased risk of cardiac arrest or intensive care unit transfer in same ward

WEDNESDAY, Dec. 28, 2016 (HealthDay News) — A critical illness event is associated with an increased risk of cardiac arrest or intensive care unit (ICU) transfer for patients on the same ward, according to a research letter published in the Dec. 27 issue of the Journal of the American Medical Association.

Samuel L. Volchenboum, M.D., Ph.D., from the University of Chicago, and colleagues conducted an observational cohort study of consecutive adult admissions from 2009 to 2013 at the University of Chicago Medicine with 13 medical-surgical wards that were geographically distinct areas and had about 20 beds per ward. Data were included for 83,723 admissions.

The researchers found that 4,286 admissions experienced the primary outcome (composite of cardiac arrest [179 events] and ICU transfer [4,107 events]). Compared with no event, when one or more than one event occurred during the previous six hours, there was an increased likelihood of cardiac arrest or ICU transfer within the next six hours (5.0 and 7.1 versus 3.6 per 1,000-patient six-hour blocks). When one or more patients developed critical illness, there was an increase in other ward patients’ risks for cardiac arrest or ICU transfer over the next six hours (one event: odds ratio, 1.18; more than one event: odds ratio, 1.53).

“The association may be explained by the diversion of resources to critically ill patients, which may result in caregivers being less attentive to other ward patients,” the authors write.

One author disclosed financial ties to the health care industry. Two authors reported a patent pending for risk stratification algorithms for hospitalized patients.

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