Association Between Initial Admission Ward and In-Hospital Mortality Among Patients Hospitalized for…

Cohort studyCirculation journal : official journal of the Japanese Circulation Society· Jul 2026

Association Between Initial Admission Ward and In-Hospital Mortality Among Patients Hospitalized for Cardiovascular Emergencies - A Nationwide Study Using the JROAD-DPC Database.

Masanari Kuwabara, Takeshi Yamamoto, Yoshio Tahara … Japanese Circulation Society Emergency and Critical Care Committee

Hospital MedicineCohort studyClinical practiceQ1IF 2.6

ICU admission linked to lower odds of in-hospital death than general ward care.

Association Between Initial Admission Ward and In-Hospital Mortality Among Patients Hospitalized for Cardiovascular Emergencies - A Nationwide Study Using the JROAD-DPC Database.

Masanari Kuwabara … Japanese Circulation Society Emergency and Critical Care Committee

Circulation journal · Jul 2026 · Q1 in General Medicine

Background

Although intensive care is considered important for cardiovascular emergencies, large-scale evidence comparing outcomes by initial admission ward remains limited in Japan.

Methods

Using the JROAD database, we identified patients hospitalized for cardiovascular emergencies after ambulance transport between April 2016 and March 2024 and classified patients by initial ward (intensive care unit [ICU], high care unit [HCU], or general ward [GW]).

Results

ICU care cut the odds of dying in hospital versus general wards

OR 0.93 (95% CI 0.91 to 0.95)

CI excludes the null - significant

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Deaths within 24 h were excluded.

In-hospital mortality was 10.8%, 9.7%, and 12.2% for patients admitted to the ICU, HCU, and GW, respectively.

A higher number of board-certified cardiologists was independently associated with lower in-hospital mortality (OR 0.977 per additional board-certified cardiologist; 95% CI 0.976-0.978).

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Findings were consistent for acute myocardial infarction, acute heart failure, aortic dissection, and pulmonary embolism.

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Conclusion

Higher-acuity admission and a higher number of cardiologists were independently associated with lower in-hospital mortality, supporting optimization of critical care access for high-risk cardiovascular emergencies in Japan.

Association Between Initial Admission Ward and In-Hospital Mortality Among Patients Hospitalized for Cardiovascular Emergencies - A Nationwide Study Using the JROAD-DPC Database.

Association Between Initial Admission Ward and In-Hospital Mortality Among Patients Hospitalized for Cardiovascular Emergencies - A Nationwide Study Using the JROAD-DPC Database.

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