Articles: outcome-assessment-health-care.
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Comparative Study
Outcome and cost of open- and closed-chest cardiopulmonary resuscitation in pediatric cardiac arrests.
The dismal survival rates of cardiac arrest in children managed with conventional closed-chest cardiopulmonary resuscitation (CC-CPR) have renewed interest in the use of open-chest CPR (OC-CPR). We determined the efficacy of the early use of OC-CPR in children after cardiac arrest. ⋯ OC-CPR does not improve survival in children who sustain cardiac arrest and receive CPR for more than 20 minutes in the field. Under these circumstances OC-CPR is an expensive and futile procedure to undertake.
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Comparative Study
Cardiopulmonary resuscitation in elderly patients hospitalized in the 1990s: a favorable outcome.
To compare the clinical characteristics and survival of elderly and younger hospitalized patients who sustain cardiac arrest and receive cardiopulmonary resuscitation (CPR) in the 1990's and to assess predictors of survival. ⋯ Elderly patients hospitalized in the 1990's who receive CPR have outcomes similar to younger patients who receive CPR. The favorable outcome in the elderly patients may reflect patient selection: the majority of our patients were functionally active prior to hospitalization, without multiple serious illnesses; many were hospitalized for acute coronary artery syndromes; and, in most cases, the arrest was witnessed with the patient's cardiac rhythm monitored at onset of the arrest.
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Stud Health Technol Inform · Jan 1994
Case-based information systems in Swedish health care. General aspects and experiences from the Stockholm County Council.
The paper gives a brief overview of some national case-based information systems in Swedish health care together with an application from the Stockholm County Council. A background section on the Swedish health care system is also included. Several case-based information systems have been developed within Swedish health care. ⋯ There is today an increased interest to use case-based information systems for quality assessment and continuous quality improvement. An increasing number of analyses are made at the local level. However, national case-based data are still very valuable to make regional comparisons possible and to produce relevant reference data in local applications.
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There are now two validated time points for predicting hospital mortality of ICU patients--at admission and at 24 hours. The best purposes include evaluation of high clinical performance ICUs and for patients being enrolled in clinical trials. For the latter purpose, the model must be calibrated in the individual hospital to ensure that the model is applicable. ⋯ The mathematical link between physiology score and estimation of hospital mortality is established only for the time point of 24 hours after ICU admission. Calibration and discrimination of the admission and 24-hour models also must be performed within each hospital in which individual probabilities are presented to families. It may be possible to customize a probability model such as MPM to achieve a high level of calibration at the individual hospital level.