Articles: outcome-assessment-health-care.
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Acta Neurochir. Suppl. · Jan 2005
Randomized Controlled TrialRelationship of cerebral perfusion pressure levels to outcome in traumatic brain injury.
This study examined the relationship of cumulative percent time that cerebral perfusion pressure (CPP) fell below set thresholds to outcome in individuals with traumatic brain injury (TBI). The sample included 157 patients (16 to 89 years of age, 79%, male) admitted to an intensive care unit at an academic medical center who underwent invasive arterial blood pressure and intracranial pressure monitoring. CPP levels were recorded continuously during the first 96 hours of monitoring. ⋯ Patients experiencing less cumulative percent time below specific CPP thresholds were more likely to have better outcome at discharge (55 mm Hg, p = .004; 60 mm Hg, p = .008; 65 mm Hg, p = .024; 70 mm Hg, p = .016). Although differences in GOSE scores at six months were not significant, those with less time below CPP thresholds were more likely to survive. Accumulated episodes of low CPP had a stronger negative relationship with outcome in patients with more severe primary brain injury.
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Randomized Controlled Trial Clinical Trial
Medical and surgical comanagement after elective hip and knee arthroplasty: a randomized, controlled trial.
Hospitalists are assuming an increasing role in the care of surgical patients, but the impact of this model of care on postoperative outcomes is unknown. ⋯ The comanagement medical Hospitalist-Orthopedic Team model reduced minor postoperative complication rates with no statistically significant difference in length of stay or cost. The nurses and surgeons strongly preferred the comanagement hospitalist model. Additional research on the clinical and economic impact of the hospitalist model in other surgical populations is warranted.
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Randomized Controlled Trial Clinical Trial
A prospective, population-based study of the epidemiology and outcome of out-of-hospital pediatric cardiopulmonary arrest.
This study reports the epidemiologic features, survival rates, and neurologic outcomes of the largest population-based series of pediatric out-of-hospital cardiopulmonary arrest patients with prospectively collected data. ⋯ The 8.6% survival rate after out-of-hospital pediatric cardiopulmonary arrest is poor. Administration of >3 doses of epinephrine or prolonged resuscitation is futile.
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Randomized Controlled Trial Clinical Trial
Randomized trial of an intensive care unit-based early discharge planning intervention for critically ill elderly patients.
Few investigators have targeted elderly patients and monitored outcomes of care in studies on discharge planning interventions after critical illness. ⋯ Intensive care unit-based early discharge planning can affect elderly patients' preparation for discharge.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Grading of subarachnoid hemorrhage: modification of the world World Federation of Neurosurgical Societies scale on the basis of data for a large series of patients.
The goals of this study were to use a large, prospectively collected, multicenter database for patients with aneurysmal subarachnoid hemorrhage (SAH) who were treated between 1991 and 1997 to determine the prognostic significance of clinical and radiological factors for outcomes and to use those factors to develop a grading scale to predict outcomes. ⋯ Outcome prediction after SAH can be improved by adding additional clinical and radiological factors to the WFNS scale, albeit with added complexity.