ArticleJournal of the American College of Emergency Physicians open2020
Emergency department crowding associated with increased 30-day mortality: a cohort study in Stockholm Region, Sweden, 2012 to 2016.
Article in Journal of the American College of Emergency Physicians open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Emergency department crowding in the modern era: a systematic review (2018-2025).Clinical and experimental emergency medicine · 2026Pooled it
- Patients' experiences of receiving hospital care from a mobile care unit - a qualitative interview study.International journal of qualitative studies on health and well-being · 2026Article
- Design and Feasibility Assessment of a Compact Emergency Unit in Rural and Remote Areas: A Multicenter Analysis of KTAS-Based Triage Data.Healthcare (Basel, Switzerland) · 2026Article
- Computerized Self-Reported Medical History Taking to Support Early Rule Out of Major Adverse Cardiac Events in Patients With Acute Chest Pain: Post Hoc Analysis of the CLEOS-CPDS Prospective Cohort Study.Journal of medical Internet research · 2026Observational
- Incident and predictors of 30-day mortality in critically ill patients after admission to the emergency department in the central region of Thailand: a prospective observational study.BMC health services research · 2026Observational
- Evaluation of the implementation process of a new emergency triage system: West coast system for triage (WEST).PloS one · 2026Article
- Individual Patient Sociodemographic Characteristics Are Associated With Waiting Time to Physician Assessment in Seven Swedish Emergency Departments: An Observational 5-Year Cohort Study of Emergency Department Visits in the Stockholm Region.Journal of the American College of Emergency Physicians open · 2025Article
- Length of stay in the emergency department and its associated input-, throughput-, and output factors at two hospitals in Sweden.BMC emergency medicine · 2025Article
- The scope of emergency nursing viewed through the lens of complex adaptive systems: A discussion paper.International journal of nursing studies advances · 2025Review
- Correlation Between Emergency Department Crowding and Adverse Occurrences in an Academic Hospital: A Retrospective Cohort Study.Risk management and healthcare policy · 2025Article
- Emergency call utilization over a 10-years period: an observational study in Region Zealand, Denmark, 2013-2022.Scandinavian journal of trauma, resuscitation and emergency medicine · 2024Observational
- Safety and Diagnostic Utility Pulmonary Embolism Rule-Out Criteria (PERC) and D-Dimer in Emergency Department.Journal of acute medicine · 2024Article
- Emergency department crowding: a national data report.Clinical and experimental emergency medicine · 2024Article
- Are medical history data fit for risk stratification of patients with chest pain in emergency care? Comparing data collected from patients using computerized history taking with data documented by physicians in the electronic health record in the CLEOS-CPDS prospective cohort study.Journal of the American Medical Informatics Association : JAMIA · 2024Article
- An observational study on the impact of overcrowding towards door-to-antibiotic time among sepsis patients presented to emergency department of a tertiary academic hospital.BMC emergency medicine · 2024Observational
- Fast track to stroke unit for patients not eligible for acute intervention, a case-control register study on 1066 patients.Scientific reports · 2023Article
- Age in addition to RETTS triage priority substantially improves 3-day mortality prediction in emergency department patients: a multi-center cohort study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2023Observational
- No waiting lying in a corridor: a quality improvement initiative in an emergency department.BMJ open quality · 2023Article
- Recurrent myocardial infarction and emergency department visits: a retrospective study on the Stockholm Area Chest Pain Cohort.Open heart · 2023Article
- Emergency department crowding and mortality: an observational multicenter study in Sweden.Frontiers in public health · 2023Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesEmergency department (ED) crowding is a major problem across the world. Studies investigating the association between crowding and mortality are many, but the quality is inconsistent and there are very few large, high-quality multicenter studies that are properly designed to deal with confounding due to case mix. The aim of this study is to investigate the association between ED crowding and 30-day mortality.
methodsWe conducted an observational cohort study at all 7 EDs in Stockholm Region, Sweden 2012-2016. The crowding exposure was defined as the mean hourly ED census during the shift that the exposed patient arrived, divided with the expected ED census for this shift. The expected ED census was estimated using a separate linear model for each hospital with year and shift as predictors. The exposure was categorized in 3 groups: reference (lowest 75% of observations), moderate (75%-95% of observations), and high (highest 5% of observations). Hazard ratios (HR) for all-cause mortality within 30 days were estimated with a Cox proportional hazards model. The model was adjusted for age, sex, triage priority, arrival hour, weekend, arrival mode, chief complaint, number of prior hospital admissions, and comorbidities.
results884,228 patients who visited the ED 2,252,656 times were included in the analysis. The estimated HR (95% confidence interval) for death within 30-days was 1.00 (0.97-1.03) in crowding category 75%-95% and 1.08 (1.03-1.14) in the 95%-100% category.
conclusionsIn a large cohort study including 7 EDs in Stockholm Region, Sweden we identified a significant association between high levels of ED crowding and increased 30-day mortality.
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