When One Patient Decompensates, Other Patients on the Ward Might Do So As Well

What happens to the rest of the patients on a hospital ward when one patient has a cardiac arrest or acutely decompensates and requires transfer to the intensive care unit (ICU)? To answer this question, investigators in Chicago retrospectively examined 84,000 patients who were admitted to 13 medical–surgical wards from 2009 through 2013.

Critical events occurred in 4286 patients: cardiac arrest in 179 and transfer to ICU in 4107. For other patients on the wards when critical events occurred in index patients, likelihood of similar events happening within the next 6 hours was higher (odds ratio, 1.18) than for patients in wards with no critical events; if multiple critical transfers or arrests occurred within the 6-hour timeframe, risk was e…