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Background: The decision to admit into the hospital from the emergency department (ED) is considered to be important and challenging. The aim was to assess whether previously published results suggesting an association between hospital bed occupancy and likelihood of hospital admission from the ED can be reproduced in a different study population. Methods: A retrospective cohort study of attendances at two Swedish EDs in 2015 was performed. Admission to hospital was assessed in relation to hospital bed occupancy together with other clinically relevant variables. Hospital bed occupancy was categorized and univariate and multivariate logistic regression were performed. Results: In total 89,503 patient attendances were included in the final analysis. Of those, 29.1% resulted in admission within 24 h. The mean hospital bed occupancy by the hour of the two hospitals was 87.1% (SD 7.6). In both the univariate and multivariate analysis, odds ratio for admission within 24 h from the ED did not decrease significantly with an increasing hospital bed occupancy. Conclusions: A negative association between admission to hospital and occupancy level, as reported elsewhere, was not replicated. This suggests that the previously shown association might not be universal but may vary across sites due to setting specific circumstances. (Less)

Altered hemostasis with a subsequent hemorrhagic diathesis is common following traumatic brain injury (TBI), and progressive intracranial bleeding is among the leading causes of preventable death following TBI. Moreover, as patients suffering from TBI are getting older, the number of TBI patients on anticoagulant and antiplatelet medication is increasing with a further increased risk for hemorrhagic progression. Thromboembolic complications are also common following TBI, with extensive thromboembolic complications occurring in 6–13% of patients after TBI. Hemorrhagic progression and thromboembolic complications occur even when conventional coagulation measurements are normal, which had led to the introduction of complementary functional tests. Still, new biomarkers and laboratory tests are needed to enable us to follow the temporal course and support future preventive measures and targeted therapies.