Langenbecks Archiv für Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft für Chirurgie. Kongress
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
[Does rationing of intensive care beds lead to premature ward return with preventable complications?].
Readmission to the surgical intensive care unit was necessary in 105 of 2269 patients (4.6%) who were discharged between 1991 and 1995. Mortality was 20% Cardiopulmonary reasons during the first 72 h after initial discharge were rare [33 patients (1.4%)].
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Guidelines for the treatment of fractures in children include social and therapeutic parameters, such as adequate hospitalization for children, a definitive therapy with a low degree of invasiveness, and a high degree of freedom of mobility. The selection of a method is linked to the patient's requests. ⋯ Therapeutic strategies should be compared not only with regard to results, but also with regard to effectivity and efficiency. There are no strict guidelines in therapeutic procedures whatsoever.
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In a cooperative effort involving each medical society the joint study group of the medical research societies in Germany (AWMF) has established guidelines for the diagnosis and treatment of various diseases. Special guidelines which pertain specifically to operative intensive care medicine do not exist. However, official recommendations have been made for intensive care management in general. ⋯ Also yet the value of those guidelines cannot be assessed. It is beyond doubt that besides being of benefit, they do present some dangers. One must point out that these guide lines are recommendations and not rules upon which medical liability may be based.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
Comparative Study[Effective costs of intensive care: TISS and TISS-28 for the evaluation of an intensive care unit].
In 1996, Miranda published the TISS-28, a simplified version of the well-known Therapeutic Intervention Scoring System (TISS) for the evaluation of intensive care. A prospective observational study in 939 patients compared both scores, and the TISS-28 was found to show less interobserver variation. A cost analysis based on 1995 data revealed a value of 68.70 DM per TISS-28 point, which can be used to calculate the average costs for groups of patients, e.g., 1410 DM for 1 day postoperative surveillance in the ICU.