The incidence and mortality of neutropenic fever in hematologic patients did not change during the SARS-CoV2 pandemic.

During the current SARS-CoV2 pandemic, fear of nosocomial infection could keep neutropenic patients from contacting the healthcare system with infection. We analyzed nationwide hospital contacts for neutropenic fever during the first seven weeks of the Danish shelter at home order. Using national registers, we extracted data on all unplanned hospital contacts due to neutropenic fever. We included 311 admissions, 13-30 per week, and found no difference between 2017-2019 and 2020. The incidence rate ratio varied between 0.68 and 1.11 with no effect on mortality. Thus, our data indicate that Danish neutropenic patients are admitted with fever, even during a pandemic.

Managers' perceptions of the effects of a national mandatory accreditation program in Danish hospitals. A cross-sectional survey.

OBJECTIVE: This study aimed to examine and compare middle and senior hospital managers' perceptions of the effects of a mandatory accreditation program in Denmark, the Danish Healthcare Quality Program (Den Danske Kvalitetsmodel [DDKM]) after it was terminated in 2015. DESIGN: A cross-sectional online questionnaire survey. SETTING: All 26 somatic and psychiatric public hospitals in Denmark. PARTICIPANTS: All senior and middle managers. METHODS: A questionnaire with open and closed response (five-point Likert scale) questions. Quantitative data were analyzed descriptively and through ordered logistic regression by management level. Qualitative data were subjected to a software-assisted content analysis. RESULTS: The response rate was 49% (533/1059). In both the qualitative and quantitative data sets, participants perceived the DDKM as having: led to an increased focus on registration, documentation and additional and unnecessary procedures. While the DDKM was perceived as increasing a focus on quality, the time required for accreditation was at the expense of patient care. There were significant differences by management level, with middle managers having more negative perceptions of the DDKM related to time spent on documentation and registration. CONCLUSION: While the DDKM had some perceived benefits for quality improvement, it was ultimately considered time-consuming and outdated or having served its purpose. Including managers, particularly middle managers, in refinements to the new quality improvement model could capitalize on the benefits while redressing the problems with the terminated accreditation program.

Can the ECG be used to estimate age-related survival?

BACKGROUND: There are few reports of the relationship between electrocardiogram (ECG) findings and the age-related survival of acutely ill patients. AIM: This study compared the 1-year survival curves of patients attending two Danish emergency departments (EDs) with normal and abnormal ECGs. Patients were divided into age groups from 20 to 90 years of age, and an abnormal ECG was defined as low QRS voltage (i.e. lead I + II <1.4 mV) or QTc interval prolongation >434 ms. METHODS: A retrospective register-based observational study on 35 496 patients attending two Danish EDs, with 100% follow-up for 1 year. RESULTS: ECG abnormality increases linearly with age, and between 30 and 70 years of age. Patients aged 20-29 years with ECG abnormalities are more than four times more likely to die within a year than patients of the same age with a normal ECG. An individual with an abnormal ECG has the same risk of dying within a year as an individual with a normal ECG who is 10 years older. After 70 years of age this tight relationship ends, but for younger individuals with an abnormal ECG the increase in mortality is even higher. CONCLUSION: An ECG may be a simple practical estimate of age-related survival. For a patient under 70 years, an abnormal QRS voltage or a prolonged QTc interval may increase 1-year mortality to that of a patient ∼10 years older.