Articles: mortality.
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Rates of death from cardiovascular and cerebrovascular diseases have been steadily declining over the past few decades. Whether such declines are occurring to a similar degree for common disorders such as acute myocardial infarction, heart failure and stroke is uncertain. We examined recent national trends in mortality and rates of hospital admission for these 3 conditions. ⋯ The rates of death and hospital admissions for acute myocardial infarction, heart failure and stroke in Canada changed at different rates over the 10-year study period. Awareness of these trends may guide future efforts for health promotion and health care planning and help to determine priorities for research and treatment.
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J. Korean Med. Sci. · Jun 2009
Acute Physiology and Chronic Health Evaluation II and Simplified Acute Physiology Score II in predicting hospital mortality of neurosurgical intensive care unit patients.
We study the predictive power of Acute Physiology and Chronic Health Evaluation II (APACHE II) and Simplified Acute Physiology Score II (SAPS II) in neurosurgical intensive care unit (ICU) patients. Retrospective investigation was conducted on 672 consecutive ICU patients during the last 2 yr. Data were collected during the first 24 hours of admission and analyzed to calculate predicted mortality. ⋯ In TBI patients, both systems had independent prognostic implications. Scoring systems are useful in predicting mortality and measuring performance in neurosurgical ICU setting. TBI patients are more affected by systemic insults than SAH patients, and this discrepancy of predicting mortality in each neurosurgical disease prompts us to develop a more specific scoring system targeted to cerebral dysfunction.
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Despite emergence of early goal directed therapy, septic shock still carries a high mortality. Gram negative septicemia is notorious for rapid deterioration due to endotoxin release. Multi-organ damage due to septic shock carries poor prognosis, and such patients should be managed aggressively with multidisciplinary approach. We present a fatal case of a patient with gram negative septicemia who rapidly deteriorated, and died due to acute refractory severe septic shock. This patient probably developed urosepsis secondary to severe urinary tract infection. He also had infiltrates on chest radiograph. He expired within fifteen hours of presenting to the emergency department. This case emphasizes the importance of early recognition and management of septic shock. Early goal directed therapy has shown to improve mortality. Broad spectrum antibiotics should be started within one hour depending on local immunity of organisms. This case also highlights the fact that despite optimized treatment, this entity has very high mortality rates. ⋯ Hemodynamic deterioration; Refractory septic shock; Gram negative septicemia.