Articles: mortality.
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Malignant middle cerebral artery infarction is associated with up to 80% mortality due to ischemic edema and brain herniation. No medical therapy has proven its efficacy in efficiently and durably reducing brain edema and improving patients' outcome. Decompressive surgery by a large hemicraniectomy with durotomy has been suggested as a life-saving emergency procedure. ⋯ Recently the results of a pooled analysis of three European randomized trials (DECIMAL, DESTINY, and HAMLET) of early (= 48 hours) decompressive large hemicraniectomy in patients less than 60 years of age showed that, compared with medical therapy alone, there was a 50% (95% CI, 33%-67%) absolute risk reduction (ARR) of death, with more patients surviving with a slight to moderate disability (modified Rankin score of 2 or 3) (ARR of 23% ) or with a slight to moderately severe disability (modified Rankin score of 2, 3, or 4) (ARR of 51% ). About 5% of all patients in each therapeutic group were left with a severe residual disability (Rankin 5). These data indicate that early decompressive hemicraniectomy should be considered and fully discussed with the relatives of selected patients with a malignant hemispheric infarction.
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The aim of this study was to assess mortality in healthy elderly patients after non-elective medical ICU admission and to identify predictive factors of mortality in these patients. ⋯ Healthy elderly non-elective medical patients admitted to the ICU have a high mortality rate related to premorbid QOL. The LI and/or EQ-5D(vas) may be useful tools to identify patients with the best chance of survival.
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Hospital readmission from the nursing home is often a concerning development for nursing home residents who have recently been dismissed from the hospital. Clinicians and family often consider the potential prognosis when residents return to the hospital. The objective was to determine the relationship between two-year mortality and 30-day hospital readmission status from the nursing home. ⋯ Older adults who are admitted to the nursing home are at significant risk of 2-year mortality with 2.5 times the odds of mortality in 2 years compared to those residents who are not readmitted. Those patients who are readmitted are older which could explain some of this difference or they could have significant comorbid illness which explains the higher mortality. When faced with residents who have multiple hospital admissions, the provider should consider potential discussion of end of life issues and advanced directives given the prognosis.
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Palliat Support Care · Mar 2009
ReviewMorbidity, mortality, and parental grief: a review of the literature on the relationship between the death of a child and the subsequent health of parents.
This review was undertaken to analyze the research to date and identify areas for future research regarding the associations between parental grief after the death of a child and the subsequent health of the parents, including both their mortality and morbidity risks. ⋯ Based on these findings, it is clear that more methodologically sound research is necessary to clarify the relationship between parental grief after the death of a child and the parents' subsequent morbidity and mortality risks.
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Scand J Public Health · Mar 2009
Comparative StudyMortality among disability pensioners in Norway and Sweden 1990--96: comparative prospective cohort study.
The aim of the study was to assess excess mortality related to disability pension (DP) status and DP diagnoses in Norway and Sweden during 1990-96. ⋯ The study confirmed an increased mortality rate among disability pensioners, except for women with musculoskeletal diagnoses. The mortality pattern related to DP diagnoses was similar in the two countries. A high frequency of musculoskeletal DP diagnoses among women with DP in Sweden explained a lower mortality rate as compared to Norway.