ED Diversion raises heart attack mortality

Patient Safety Monitor Insider

June 15, 2011

Heart attack patients have a higher risk of dying within a year if the closest ED is on diversion as opposed to operating normally on the day they get sick, according to a Robert Wood Johnson-funded study that is the first of its kind, published in the Journal of American Medical Association (JAMA).

"If you have 100 patients admitted to an emergency department with a heart attack, 29 of them are likely to die under normal operations," when the hospital was not on diversion at all that day, within the following year, says Yu-Chu Shen of the Naval Postgraduate School in Monterey, the report's principal author.

"But if [those] same 100 patients had a heart attack on a day when their closest hospital was on diversion for 12 hours or more, the number of patients who would die would go up to 32%. You're going to have an additional three deaths that are potentially avoidable if those patients had not been subject to longer diversion," Shen says.

Presumably, the additional deaths occurred because delays in treatment resulting from busier ED staff or increased transport times equated to greater heart muscle damage, greater oxygen deprivation or other adverse consequences.

Sources: HealthLeaders Media, JAMA