Crit Care Resusc
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To compare the impact of the 2013 Australian and New Zealand Risk of Death (ANZROD) model and the 2002 Acute Physiology and Chronic Health Evaluation (APACHE) III-j model as risk-adjustment tools for benchmarking performance and detecting outliers in Australian and New Zealand intensive care units. ⋯ The ANZROD model reduces variability in SMRs due to casemix, as measured by overdispersion, and facilitates more consistent identification of true outlier ICUs, compared with the APACHE III-j model.
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Trials in critical care have previously used unvalidated systems to classify cause of death. We aimed to provide initial validation of a method to classify cause of death in intensive care unit patients. ⋯ The ICU-DECLARE system allowed ICU doctors to classify the proximate cause of death of patients who died in the ICU with substantial reliability.
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To describe the incidence and mortality of postoperative sepsis in New South Wales, Australia. ⋯ Over 8 years, the mortality from postoperative sepsis decreased, but its incidence rate increased, resulting in a lack of improvement in the incidence rate of sepsis-related deaths. The increasing incidence of postoperative sepsis and the poor record of identification of causative organisms remain a significant public health challenge.
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To evaluate whether the admission of a palliative patient to the intensive care unit for end-of-life care and consideration of organ donation provides an equivalent net benefit in quality-adjusted life-years (QALYs) compared with the admission of a non-palliative patient for active management. ⋯ The admission of a dying patient to the ICU when organ donation may be possible is of considerable community benefit, yielding an average of over seven times the QALYs per ICU bed-day compared with the average benefit for ICU patients expected to survive. When it is possible to offer end-of-life care in the ICU, it should not be denied on the basis of concerns about lack of benefit or inappropriate use of resources.