Articles: hospitals.
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Pediatric emergency care · Apr 2014
Multicenter StudyPrevalence of Electrocardiogram Use in Infants With Apparent Life-Threatening Events: A Multicenter Database Study.
An apparent life-threatening event (ALTE) is a common diagnosis in pediatrics, but there is no standardized method to evaluate these patients. We sought to determine the prevalence of electrocardiogram (ECG) use in patients presenting to children's hospitals with an ALTE. ⋯ Electrocardiograms are performed in fewer than half of patients with ALTE presenting to children's hospitals. There is wide variation in the prevalence of ECG use as a diagnostic tool for infants presenting with an ALTE.
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Multicenter Study Comparative Study
Does the effect of surgical volume on outcomes diminish over time?
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Reg Anesth Pain Med · Mar 2014
Multicenter Study Comparative StudyDoes the Impact of the Type of Anesthesia on Outcomes Differ by Patient Age and Comorbidity Burden?
Neuraxial anesthesia may provide perioperative outcome benefits versus general anesthesia in orthopedic surgical patients. As subgroup analyses are lacking, we evaluated the influence of the type of anesthesia on outcomes in patient groups of different age and the presence of cardiopulmonary disease. ⋯ Neuraxial anesthesia is associated with decreased odds for major complications and resource utilization after joint arthroplasty for all patient groups, irrespective of age and comorbidity burden.
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Randomized Controlled Trial Multicenter Study
Hospital variation in intravenous inotrope use for patients hospitalized with heart failure: insights from Get With The Guidelines.
Prior claims analyses suggest that the use of intravenous inotropic therapy for patients hospitalized with heart failure varies substantially by hospital. Whether differences in the clinical characteristics of the patients explain observed differences in the use of inotropic therapy is not known. ⋯ Use of intravenous inotropic agents during hospitalization for heart failure varies significantly among US hospitals even after accounting for patient and hospital factors.
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Critical care medicine · Mar 2014
Multicenter Study Comparative StudyWhen Policy Gets It Right: Variability in U.S. Hospitals' Diagnosis of Ventilator-Associated Pneumonia.
The Centers for Disease Control has recently proposed a major change in how ventilator-associated pneumonia is defined. This has profound implications for public reporting, reimbursement, and accountability measures for ICUs. We sought to provide evidence for or against this change by quantifying limitations of the national definition of ventilator-associated pneumonia that was in place until January 2013, particularly with regard to comparisons between, and ranking of, hospitals and ICUs. ⋯ In this nationally representative study of hospitals, assignment of ventilator-associated pneumonia is extremely variable, enough to render comparisons between hospitals worthless, even when standardized cases eliminate variability in clinical data abstraction. The magnitude of this variability highlights the limitations of using poorly performing surveillance definitions as methods of hospital evaluation and comparison, and our study provides very strong support for moving to a more objective definition of ventilator-associated complications.