Journal of the American College of Surgeons
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The elderly consume up to one third of health care resources and have become a target for cost reduction efforts. This study was performed to evaluate elderly survivors of surgical critical illness using perceived quality of life and activities of daily living as indicators of value of care. ⋯ Although overall functional levels fell, rates of full dependency rose only slightly and perceived quality of life was high in a group of elderly patients surviving surgical intensive care. High hospital and postdischarge mortality should not motivate restriction of care for elderly patients requiring surgical intensive care given their high postillness subjective quality of life measures.
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Comparative Study
TRISS methodology: an inappropriate tool for comparing outcomes between trauma centers.
The TRISS methodology has been used for comparison of survival outcomes between trauma centers. The purpose of this study was to evaluate the role of TRISS in comparing outcomes between a small and a large trauma center and evaluate its usefulness in various groups of patients. ⋯ The TRISS methodology is not a reliable tool for comparing outcomes between trauma centers and has an unacceptably high misclassification rate in patients with severe trauma.