{
  "abstract": "BACKGROUND: Although intensive care is considered important for cardiovascular emergencies, large-scale evidence comparing outcomes by initial admission ward remains limited in Japan. METHODS AND RESULTS: 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]). Deaths within 24 h were excluded. Multivariable logistic regression analysis was performed with adjustment for demographics, comorbidities, acute therapies, and hospital cardiologist staffing. Among 1,211,636 admissions, there were 323,220 (26.7%) deaths within 24 h; thus, 888,416 admissions (ICU, 212,059; HCU, 124,468; GW, 551,889) were analyzed. In-hospital mortality was 10.8%, 9.7%, and 12.2% for patients admitted to the ICU, HCU, and GW, respectively. Compared with the GW, the adjusted odds of death were lower for the ICU (odds ratio [OR] 0.718; 95% confidence interval [CI] 0.703-0.734) and HCU (OR 0.928; 95% CI 0.906-0.950). 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). Findings were consistent for acute myocardial infarction, acute heart failure, aortic dissection, and pulmonary embolism. CONCLUSIONS: 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.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 22,
  "authors": [
    {
      "name": "Masanari Kuwabara"
    },
    {
      "name": "Takeshi Yamamoto"
    },
    {
      "name": "Yoshio Tahara"
    },
    {
      "name": "Migaku Kikuchi"
    },
    {
      "name": "Hiroshi Imamura"
    },
    {
      "name": "Ichiro Takeuchi"
    },
    {
      "name": "Naoki Sato"
    },
    {
      "name": "Tomonori Itoh"
    },
    {
      "name": "Yoko Sumita"
    },
    {
      "name": "Yoshihiro Miyamoto"
    },
    {
      "name": "Shiro Ishihara"
    },
    {
      "name": "Kikuo Isoda"
    },
    {
      "name": "Tomoko Ishizu"
    },
    {
      "name": "Yuji Ikari"
    },
    {
      "name": "Shuzou Tanimoto"
    },
    {
      "name": "Yae Matsuo"
    },
    {
      "name": "Ryosuke Murai"
    },
    {
      "name": "Takanori Ikeda"
    },
    {
      "name": "Hiroyuki Okura"
    },
    {
      "name": "Yoshio Kobayashi"
    },
    {
      "name": "Kuniya Asai"
    },
    {
      "name": "on behalf of Japanese Circulation Society Emergency and Critical Care Committee"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9p9vxm7es2fs7.bib",
  "cited_by": 0,
  "doi": "10.1253/circj.cj-26-0310",
  "fulltext_url": "https://www.jstage.jst.go.jp/article/circj/advpub/0/advpub_CJ-26-0310/_article",
  "id": "9p9vxm7es2fs7",
  "issns": [
    "1347-4820",
    "1346-9843"
  ],
  "landing_url": "https://www.jstage.jst.go.jp/article/circj/advpub/0/advpub_CJ-26-0310/_article",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "jstage-journal",
      "medicine/cardiovascular"
    ],
    [
      "openalex",
      "2705|Acute Myocardial Infarction Research"
    ]
  ],
  "openalex": "W7171819038",
  "pdf_url": "https://www.jstage.jst.go.jp/article/circj/advpub/0/advpub_CJ-26-0310/_pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-07-31",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/9p9vxm7es2fs7.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:24Z",
      "native_id": "10.1253/circj.cj-26-0310",
      "source": "jstage",
      "url": "https://www.jstage.jst.go.jp/article/circj/advpub/0/advpub_CJ-26-0310/_article"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Acute Myocardial Infarction Research",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Association Between Initial Admission Ward and In-Hospital Mortality Among Patients Hospitalized for Cardiovascular Emergencies ― A Nationwide Study Using the JROAD-DPC Database ―",
  "title_text": "Association Between Initial Admission Ward and In-Hospital Mortality Among Patients Hospitalized for Cardiovascular Emergencies ― A Nationwide Study Using the JROAD-DPC Database ―",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:24Z",
  "url": "https://research.draconitic.com/paper/9p9vxm7es2fs7",
  "venue": "Circulation Journal",
  "versions": []
}