M Sibé | PubMed Health

PubMed2001

[Blunt trauma to the infrarenal abdominal aorta with neurologic lesions. Case report and review of the literature].

We report the case of a 31-year-old female involved in a severe motor vehicle accident. The diagnosis of blunt trauma to the abdominal aorta was not retained initially. The patient was referred to our institution when she developed a delayed paralysis of the lower limbs associated with the disappearance of both femoral pulses. Computed tomography evidenced dissection of the infrarenal aorta and NMR ruled out injury to the spinal cord. An aortoiliac endarteriectomy was then performed. Neurological recovery was partial at 3 months. We reviewed the frequency, the mechanisms and the management of blunt trauma to the abdominal aorta.

Accidents, Traffic↗

PubMed2000

[Process assessment: importance and current limits].

Assessment of processes in health care is needed for the measurement of six domains of quality of care (appropriateness, security, respect and caring, availability, continuity and timeliness). We propose here a typology of care, organisational and management processes. Process indicators can be classified according to objectives of the evaluation, type of processes, concerned healthcare professionals, and stage of the process. Process assessment is hindered by two main difficulties. Due to the lack of data about processes in information systems and in medical records, specific data collection is often needed and impede the feasibility of routine evaluation. The second difficulty is related to the lack of information about the properties of the indicators, their appropriateness (capacity to infer improvement actions from the result of the indicators), their operational properties (cost of data collection and acceptability by the concerned professionals), and their measurement properties (reliability and validity). Process assessment is strongly needed because outcome assessment can be not possible or not appropriate. The lack of information about the process-outcome relationship is the major obstacle and the main contra-indication to its use. Validation of process indicators is therefore an important research area for the future.

Delivery of Health Care↗