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At least 523 records · Page 29Linked to original sources
PubMed1989

Outcome from intensive care. II. A 5-year study of 1308 patients: short-term outcome.

All patients (n = 1308) admitted to a multidisciplinary intensive care unit (ICU) during a 5-year period (1979-83) were followed prospectively. The in-unit mortality was 18% and the in-hospital mortality (mortality during ICU-stay plus mortality during the ensuing hospital stay) was 29%. Increasing age was associated with increasing in-hospital mortality, up to 40% mortality rate in patients aged 80 years and older. Using multiple logistic regression analyses, prognostic factors for mortality were identified. Risk factors for death in the ICU included age, cardiovascular diseases, sepsis, adult respiratory distress syndrome and acute renal failure. Cancer did not appear as a risk factor. The mortality during the ensuing hospital stay, however, was significantly influenced by cancer as well as the aforementioned risk factors. When controlled for severity of illness, expressed by the level of organ system failure after 48 h of ICU treatment, only sex, sepsis and severity of illness showed significant influence on the mortality in the ICU, and only sex and severity of illness significantly influenced mortality during the ensuing hospital stay after discharge from the ICU.

Adult↗
PubMed1995

Developing an outcomes infrastructure for nursing. The Outcomes Taskforce.

An infrastructure to support the evaluation of patient care sensitive to the intervention of nursing personnel is being developed within a major health maintenance organization. In addition to traditional administrative measures of care, the database infrastructure will include measures of the patient's functional status, knowledge and engagement in care and psychosocial well-being. These measures are believed to be particularly sensitive to the independent intervention of the nurse. Reported here are the structures in place to monitor and support the reliability and validity of the administrative data elements; algorithm elements created to account for missing data; the model for the first generation of successful practice reports and the results of a study establishing the content validity of the clinical data elements.

Costs and Cost Analysis↗
PubMedDate not supplied

Presentation and outcome of sporadic acute bacterial meningitis in children in the African meningitis belt: recent experience from northern Nigeria highlighting emergent factors in outcome.

Sixty-six (19.4%) of 341 acutely ill infants and children (> 1 mo-15 yr old) who had a lumbar puncture (LP) done during an inter-epidemic period had bacterial meningitis (BM). No clinical feature was sufficiently characteristic of the presence of BM. Twenty (30.3%) of the 66 patients with BM lacked typical signs of meningitis at the time of diagnosis whereas 61 (22.2%) of the 275 with other illnesses had signs. Three (4.6%) of the 66 patients with BM were discharged against medical advice, 31 (47%) survived intact and 16 (24.2%) each died or survived with sequelae. Case fatality rate was significantly higher in children with coma, focal extracranial infections, delayed diagnosis of BM after admission, irregular administration of antibiotic drugs and treatment with dexamethasone. Among survivors, sequelae rate was significantly higher in children with delayed presentation, convulsions, coma, and prolonged hospitalisation (> 10 days); sequelae rate in patients with convulsions was significantly higher in those with complex convulsions and convulsions occurring after 24 hours of treatment. Irregular provision of drugs by parents and delay in the diagnosis of BM after admission are emergent factors which, in addition to the well known factors of malnutrition and delayed presentation, further worsen the prognosis of BM. A more liberal policy in the use of LPs in acutely ill children is advocated to reduce the risk of missed diagnosis.

Adolescent↗