Crowded Emergency Rooms Trouble for Heart Patients

Kathleen Blanchard's picture

Results of a new study show that visiting a crowded emergency room may spell trouble for heart patients. The findings, published in the journal Academic Emergency Medicine, show that patients with chest pain are three to five times more likely to develop complications when admitted to the hospital through a busy and crowded emergency room. The authors say a crowded emergency room is an indication that a hospital is not functioning properly.

According to study author Jesse M. Pines, M.D., MBA, assistant professor of emergency medicine and epidemiology at the Hospital of the University of Pennsylvania, “What shocked us is that these complications were not explained by what goes on in the ED, like getting aspirin or a rapid electrocardiogram. The adverse events occurred after the patient had been admitted to the hospital. Emergency department crowding is really more of a marker of a dysfunctional hospital.”

The study followed 4,574 patients who were admitted to the Hospital of the University of Pennsylvania for complaints of chest pain, over an eight-year period – 802 patients were diagnosed with acute coronary syndrome (sudden onset of chest pain). Complications rates were serious in 251 out of 273 patients who had true heart attacks and included cardiac arrest, congestive heart failure, hypotension, heart rhythm disturbances and delayed heart attack. The patients were three times more likely to develop serious complications when the emergency room was crowded. Long waiting times resulted in five the likelihood that patients with chest pain would experience serious complications.


The authors say crowded emergency rooms are “a national public health problem”. They are not sure exactly why crowded emergency rooms spell such trouble for heart patients, but suspect the cause is overburdened staff, delays in lab tests and poor coordination of patient care, and long holding times in the emergency room before getting to a hospital room.

Judd E. Hollander, M.D., the study’s senior author and professor of emergency medicine at Penn says, “While it’s difficult to know what complications are truly preventable, what we do know is that crowding is preventable. But hospitals have to allocate enough resources to their emergency departments so that errors are caught early and patients don’t suffer.” Insurance companies refuse to pay for unnecessary complications that occur during patient hospital stays.

When hospital emergency rooms are crowded, patients suffer. According to Dr. Hollander, there is no accountability for waiting times in crowded emergency rooms.

The authors hope that hospital administrators, policy makers, and emergency room physicians take note, and combine efforts to try to find solutions to overcrowded emergency rooms, a problem that leads to serious complications for patients once they are admitted to the hospital, especially heart patients.

Blackwell Publishing