Articles: hospitals.
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Randomized Controlled Trial Multicenter Study
Effects of dexamethasone on cognitive decline after cardiac surgery: a randomized clinical trial.
Cardiac surgery can be complicated by postoperative cognitive decline (POCD), which is characterized by impaired memory function and intellectual ability. The systemic inflammatory response that is induced by major surgery and cardiopulmonary bypass may play an important role in the etiology of POCD. Prophylactic corticosteroids to attenuate the inflammatory response may therefore reduce the risk of POCD. The authors investigated the effect of intraoperative high-dose dexamethasone on the incidence of POCD at 1 month and 12 months after cardiac surgery. ⋯ Intraoperative high-dose dexamethasone did not reduce the risk of POCD after cardiac surgery.
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Randomized Controlled Trial Multicenter Study
A multicentre, randomised, double-blind, placebo-controlled trial of aminophylline for bronchiolitis in infants admitted to intensive care.
To determine whether aminophylline reduced the duration of respiratory support in children admitted to intensive care with bronchiolitis. ⋯ Not enough children were recruited for the study to test the hypothesis that aminophylline reduces the need for respiratory support in severe bronchiolitis. Consequently, the role of aminophylline in the management of severe bronchiolitis remains unknown.
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Multicenter Study Comparative Study
Differences in hospital performance for noncancer vs cancer colorectal surgery.
Considerable hospital-to-hospital variations in surgical outcomes have been reported across surgical procedures. However, it is unclear whether hospital quality rankings are consistent for noncancer and cancer operations. We investigated the differences in hospital performance for noncancer and cancer colorectal resections at 52 hospitals participating in the Michigan Surgical Quality Collaborative (MSQC). ⋯ A hospital's performance ranking in risk-adjusted outcomes after noncancer colorectal resections does not correlate to its performance for cancer-related colorectal resections. Indication for operation should be considered when leveraging risk-adjusted hospital outcomes for quality improvement efforts.
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To measure the hospital-level variation in admission rates for children receiving treatment of common pediatric illnesses across emergency departments (EDs) in US children's hospitals. ⋯ We observed greater than threefold variation in severity-adjusted admission rates for common pediatric conditions across US children's hospitals. Although local practices and hospital-level factors may partly explain this variation, our findings highlight the need for greater focus on the standardization of decisions regarding admission.
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Multicenter Study Comparative Study
The impact of implementing a rapid response system: A comparison of cardiopulmonary arrests and mortality among four teaching hospitalsin Australia.
To compare clinical outcomes between a teaching hospital with a mature rapid response system (RRS), with three similar teaching hospitals without a RRS in Sydney, Australia. ⋯ Implementation of a RRS was associated with a significant reduction in IHCA, IHCA-related mortality and overall hospital mortality.