Articles: mortality.
-
Bmc Pregnancy Childb · Jan 2006
Protocol for the immediate delivery versus expectant care of women with preterm prelabour rupture of the membranes close to term (PPROMT) Trial [ISRCTN44485060].
Preterm prelabour rupture of membranes (PPROM) complicates up to 2% of all pregnancies and is the cause of 40% of all preterm births. The optimal management of women with PPROM prior to 37 weeks, is not known. Furthermore, diversity in current clinical practice suggests uncertainty about the appropriate clinical management. There are two options for managing PPROM, expectant management (a wait and see approach) or early planned birth. Infection is the main risk for women in which management is expectant. This risk need to be balanced against the risk of iatrogenic prematurity if early delivery is planned. The different treatment options may also have different health care costs. Expectant management results in prolonged antenatal hospitalisation while planned early delivery may necessitate intensive care of the neonate for problems associated with prematurity. ⋯ This trial will provide evidence on the optimal care for women with PPROM close to term (34-37 weeks gestation). Consideration of both the clinical and economic sequelae of the management of PPROM will enable informed decision making and guideline development.
-
In Mozambique most of demographic data are obtained using census or sample survey including indirect estimations. A method of collecting longitudinal demographic data was introduced in southern Mozambique since 1996 (DSS -Demographic Surveillance System in Manhiça district, Maputo province), but the extent to which it yields demographic measures that are typical of southern rural Mozambique has not been evaluated yet. ⋯ The population under demographic surveillance in Manhiça district presents characteristics that are typical of southern rural Mozambique, with predominance of young people and reduction of adult males. Labour migration and excess adult male mortality are the major factors for the reduction of adult males. Mortality is high and only infant mortality has started to stabilise while adult mortality has increased, and as consequence, life expectancy has decreased. The Manhiça DSS is an adequate tool to report demographic measures for southern rural Mozambique.
-
Stud Health Technol Inform · Jan 2006
Artificial neural network versus subjective scoring in predicting mortality in trauma patients.
Current methods of trauma outcome prediction rely on clinical knowledge and experience. This makes the system a subjective score, because of intra-rater variability. This project aims to develop a neural network for predicting survival of trauma patients using standard, measured, physiological variables, and compare its predictive power with that obtained from current trauma scores. ⋯ An ANN developed using pre-hospital physiological variables without using subjective scores resulted in good mortality prediction when applied to a test set. Its performance was too sensitive and requires refinement.
-
There have been few studies to date that investigate the effect of race on outcomes related to coronary artery bypass grafting. The objective of the present study was to investigate race as an independent predictor of outcomes among patients undergoing coronary artery bypass graft (CABG). A nested case-control study from a twelve-year hospitalization cohort (N=9671) in which data were collected prospectively was conducted. ⋯ Multivariate analysis revealed African-Americans were at greater risk for renal complications (OR 1.88, 95% CI 1.27-2.77), neurological complications (OR 1.34, 95% CI 1.01-1.77), and pulmonary complications (OR 2.11, 95% CI 1.72-2.59). African Americans had a significantly longer hospitalization post-operatively (OR 0.79, 95% CI 0.66-0.96), but were less likely to experience post-operative atrial fibrillation requiring treatment than Caucasians (OR 0.64, 95% CI 0.49-0.84). Even after multiple adjustments, African-Americans undergoing CABG surgery had significantly greater morbidity compared to Caucasian patients.
-
The objective of this descriptive study was to relate hematological parameters of patients visiting the emergency department (ED) to mortality. The study included 1698 adult patients visiting the ED for any reason who underwent blood gas analysis. The results of hemoglobin concentration, leukocyte count, and platelet count were related to mortality within 7 days after admittance to the hospital. ⋯ This showed higher mortality in the groups of patients with leukocyte counts outside the reference range (4.0-10.0 x 10 (9)/L, p < .01) and in the group of patients with platelet counts below the reference range (150-450 x 10 (9)/L, p < .0001). High mortality is also seen in the group of women with hemoglobin concentrations outside the reference range (12.1-15.7 g/dL, p < .01), for men no difference was observed. In conclusion, our study shows clinically relevant differences in mortality in hematological parameters in an unselected population at the ED, irrespective of underlying pathology.