Articles: mortality.
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Pediatr Crit Care Me · Oct 2000
Relevance of diagnostic diversity and patient volumes for quality and length of stay in pediatric intensive care units.
Investigation of associations of the diagnostic diversity and volumes with efficiency and quality of care. ⋯ Patient volumes encountered in a PICU are important for maintaining quality and efficiency of care. In low-volume units, fewer diagnoses and higher volumes were both associated with higher efficiencies. In high volume units, diagnosis-specific volumes were generally large enough for achieving diagnosis-independent efficiency. Diagnostic mix was not associated with PICU mortality ratios, but higher PICU volumes were associated with lower mortality rates.
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Both attenuated heart rate recovery following exercise and the Duke treadmill exercise score have been demonstrated to be independent predictors of mortality, but their prognostic value relative to each other has not been studied. ⋯ In this cohort of patients referred specifically for exercise electrocardiography, both abnormal heart rate recovery and treadmill exercise score were independent predictors of mortality. Heart rate recovery appears to provide additional prognostic information to the established treadmill exercise score and should be considered for routine incorporation into exercise test interpretation. JAMA. 2000;284:1392-1398.
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The declining prevalence of left-handed individuals with increasing age has led to two main avenues of hypotheses; the association is due either (1) to a birth cohort effect and/or an age effect caused by a switch to right-handedness with advancing age or (2) to mortality selection that reduces survival in left-handed individuals, or both. It is uncertain whether a cohort or age effect can explain the decline in age-related prevalence, and conflicting evidence exists in favor of the mortality hypothesis. We compared mortality in a subgroup of 118 opposite-handed twin pairs by counting in how many instances the right-handed twin died first. ⋯ In 50% of monozygotic pairs, right-handed twins died first. The prevalence of not being right-handed was higher among males (9.2%) than females (6.5%); there was a similar frequency of non-right-handedness in monozygotic (8.0%) and dizygotic (7.8%) twins. We did not find evidence of excess mortality among non-right-handed adult twins in this follow-up study.
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To review the strategies for identification and subsequent management of high-risk patients that have been proposed to reduce perioperative morbidity and mortality. ⋯ In patients who are about to undergo major intra-abdominal surgery, preoperative cardiopulmonary exercise testing is an excellent predictor of risk in the postoperative period. No other test is able to offer such a comprehensive preoperative risk evaluation for an operative patient.
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To examine national variation in use of the Medicare hospice benefit by older individuals before their death, and to identify individual characteristics and local market factors associated with hospice use. ⋯ The wide variation in hospice use suggests that there is great potential to increase the number of users of the Medicare hospice benefit.