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Biomedical subjects

A G Whitfield

Publications and source records attributed to A G Whitfield.

13 recordsLinked to original sources
PubMed1990

Mortality in elderly patients admitted for respite care.

OBJECTIVE: To determine whether admitting elderly patients to hospital to give temporary relief to their carers is associated with increased mortality. DESIGN: Prospective multicentre study comparing the mortality of patients admitted on a one off or rotational basis with that experienced while they were awaiting admission. SETTING: A wide range of urban and rural district general, geriatric or long stay, and general practitioner hospitals. PATIENTS: 474 Patients aged 70 or over who had 601 admissions. MAIN OUTCOME MEASURE: Death. RESULTS: 16 (3.4%) Of the 474 patients (2.7% of all 601 admissions) died while in hospital during an average stay of 15.7 days whereas 23 (4.9%) patients died while awaiting admission (average waiting time was 34.2 days). The 16 deaths in hospital and the 23 deaths during the longer waiting period correspond to death rates of 19.9 and 12.5 per 10,000 person days respectively. The difference between these of 7.4 is not statistically significant (95% confidence interval -3.6 to 18.3). The estimated relative risk of dying in hospital is 1.59 but the 95% confidence interval is wide (0.84 to 3.01). CONCLUSION: Although the death rates are slightly higher in those admitted to hospital for relief care than in those awaiting admission, the difference was not significant, and the death rate in both groups was reassuringly small.

Aged↗
PubMed1979

Deaths from rhesus haemolytic disease in England and Wales in 1977: accuracy of records and assessment of anti-D prophylaxis.

All the death certificates for deaths in 1977 where haemolytic disease of the newborn (HDN) was the principal, an antecedent, or a contributory cause were obtained from the Office of Population Censuses and Surveys (OPCS). The hospital notes of all 54 of the live-born cases and all of the 101 stillbirths were also obtained. The cause of the death indicated by the notes was compared with the cause and coding on the death certificate. In about a quarter of the cases death was not due to haemolytic disease of any type. The commonest errors arose because the International Classification of Diseases (8th edition) stipulates that hydrops without mention of cause should be coded as HDN and because stillbirths to rhesus-negative mothers tend to be attributed to rhesus HDN automatically. Though deaths from HDN may be overestimated in this way, they are also underestimated because rhesus disease, although mentioned on the certificate, is not selected as the underlying cause, which it may be. These cases were found through multiple coding of all the contributory causes of death, which OPCS performs on a 25% sample of all death certificates for research purposes. These two sources of inaccuracy tend to cancel each other out, but statistics from death certificates give a misleading picture of the efficacy of anti-D prophylaxis because anti-D can never prevent cases which are not in fact due to rhesus HDN. Most of the mothers studied had become immunised before anti-D became available, but in those who could have been treated 75% had not received prophylaxis. As this was a sample of deaths, however, it would not be accurate to extrapolate this high figure to the population at risk. Nevertheless, the organisation of prophylaxis is clearly deficient and should be remedied before providing antenatal anti-D to supplement postnatal treatment.

Death Certificates↗
PubMed1979

Peel's fall.

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Accidents↗
PubMed1978

Biochemical and haematological markers of alcohol intake.

The serum gamma-glutamyl-transpeptidase (gamma-G.T.), aspartate transaminase (A.T.), urate, and triglyceride levels and the mean cell volume were estimated in 2034 healthy men. In 14.9% gamma-G.T. was elevated, in 8.0% A.T. was raised, and in 4.2% both enzymes were elevated. Findings were almost identical in a subgroup of 146 whose alcohol intake was known. Both enzymes, serum-urate, and mean cell volume showed a progressive rise with increasing alcohol consumption. The sensitivity of these markers is such that elevated levels are present in those whose alcohol intake would be regarded as normal and who are in no sense alcohol-dependent.

Adult↗
PubMed1975

The chest radiograph in ankylosing spondylitis.

In a study of 42 patients with ankylosing spondylitis, upper lobe fibrosis was present in six (14-3%) patients. All the patients with upper lobe fibrosis had total spinal ankylosis, and half showed peripheral joint involvement. A further 13 patients (30-9%) had other focal pulmonary abnormalities compared with only six (14-3%) of a group of age-matched controls. There was no correlation between the radiological extent of the disease (spinal changes and pulmonary involvement) and any of the haematological or biochemical parameters measured. Treatment with radiotherapy was not responsible for these changes.

Adult↗