Articles: hospitals.
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The American surgeon · Aug 1977
Comparative StudyAbdominoperineal resection for carcinoma in the community hospital.
Stimulated by a report in 1974, we have reviewed all abdominoperineal resections in a Univeristy-affiliated community hospital. From 1964--1973, 67 such procedures were performed. There were 65 adenocarcinomas, one squamous cell cancer, and one carcinoid tumor. ⋯ Postoperative complications occurred in 55.1% of patients. Late complications occurred in 22% of patients. Five-year follow-up was possible in 34 patients with an overall survival of 50%.
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A disproportionately high percentage of trauma fatalities occur in rural areas. Almost half of these fatalities occur after arrival at a community hospital. A review of the initial evaluation and management of major trauma victims in rural community hospitals in the intermountain West revealed a surprisingly high incidence of departure from well defined standards. Reducing the magnitude of this rural hospital component of trauma facilities will require application of the same standards of initial evaluation and management which have proved effective in major medical center emergency department settings.
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Septicemia developed in 34 patients per 10,000 admissions to a community hospital during 1970 through 1973. Two thirds of the 207 patients had community-acquired septicemia, and one third had nosocomial septicemia. Septicemia-related mortality was 20.3%. ⋯ Septicemia was associated with shock in 9.7% of the patients. Foley catheterization and prophylactic antibiotic therapy could not be implicated as major risk factors for the development of septicemia. This study shows an incidence of Gram-negative bacteremia, septic shock, and mortality substantially less than that described in published data from noncommunity hospitals.