Archives of surgery (Chicago, Ill. : 1960)
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Comparative Study
Postoperative mortality after surgery for brain tumors by patient insurance status in the United States.
To examine whether being uninsured is associated with higher in-hospital postoperative mortality when undergoing surgery in the United States for a brain tumor. ⋯ Uninsured patients who underwent craniotomy for a brain tumor experienced the highest in-hospital mortality. Differences in overall health do not fully account for this disparity.
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OBJECTIVE To investigate the relationship between oxygenation and short-term outcomes in patients with traumatic brain injury (TBI). DESIGN Logistic regression analysis was used to determine whether average high (>200 mm Hg) or low (<100 mm Hg) PaO2 levels within the first 24 hours of hospital admission correlated with patient outcomes relative to patients with average PaO2 levels between 100 and 200 mm Hg. SETTING Level 1 trauma center. ⋯ Although the mechanism for this has not been completely elucidated, it may involve hyperoxia-induced oxygen-free radical toxicity with or without vasoconstriction. Hyperoxia and hypoxia were found to be equally detrimental to short-term outcomes in patients with TBI. A narrower therapeutic window for oxygenation may improve mortality and functional outcomes.