ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb119437.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb119438.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb119439.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb119440.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Objective:To analyse the demographic characteristics and outcomes of patients with rupture of an intracranial aneurysm ‐ to make a comparison with other published results, and to determine whether improvements in management can be made.Design:A retrospective review of the records of a consecutive series of 102 patients admitted to a neurosurgical unit in 1988 and 1989.Setting:The Royal Brisbane Hospital neurosurgical unit.Patients:Sixty‐three women and 39 men with subarachnoid haemorrhage after rupture of an intracranial aneurysm.Main results:Sixty‐three patients achieved independence and 32 died. Of those 78 patients who were able to be offered surgery,60 (77%) became independent. The outcome was significantly influenced by the neurological condition of the patient on lid mission to hospital (P<0.01).Conclusion:A speedier referral of these patients to a neurosurgical unit may lead to an improvement in outcome.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb119441.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Objective:To determine the outcome in patients with subarachnoid haemorrhage from a ruptured aneurysm, particularly in those in who,“ the diagnosis w.as delayed.Design:A two‐year retrospective study of medical records of patients admitted to Westmead Hospital between July 1988 and June 1989.Setting:A tertiary level teaching hospital.Patients:Ninety‐four patients treated for subarachnoid haemorrhage. In 15 cases the diagnosis was delayed.Main outcome measures:Death, disability, or functional recovery.Results:Overall, 40 (42.5%) patients died, 14 (15%) were disabled, and 40 made a functional recovery. Of the 62 patients who were treated surgically 38 (61%) made a functional recovery compared with two of the 32 (6%) who were not. Of the 15 in whom the diagnosis was delayed seven (47%) made a functional recovery. Confirmation of the diagnosis was delayed in four of the latter group because a cranial computed tomography scan showed no abnormalities.Conclusions:Earlier diagnosis, allowing early definitive surgical treatment, may improve the outcome in aneurysmal subarachnoid haemorrhage; The results ofa computed tomography scan are diagnostic only if they are positive ‐ a negative result must be interpreted in conjunction with the clinical picture.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb119442.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Objective:To examine the impact of the introduction of dry chemistry pathology in general practice.Design and setting:A two‐period crossover trial in two groups of general practices.Participants:Twenty‐eight general practices with an interest in participating in a trial of the new technology were selected from practices related to the coordinating hospitals.Intervention:Each practice was observed in its usual operation for one of the two study periods and observed using a dry chemistry analyser during the other.Main outcome measures:Laboratory pathology tests and analyser tests were recorded during the study period. General practice records were searched to assess the impact of dry chemistry pathology on the detection of new disease (anaemia) and the control of existing disease (diabetes; and hyperkalaemia or hypokalaemia). Questionnaires were given to patients and general practitioners to assess their perceptions of the new technology. Imprecision of the analysers was assessed by use of their internal control material and inaccuracy was assessed by split sample analysis in comparison with standard laboratory tests.Results:Use of analysers was associated with a 2% non‐significant reduction in the use of laboratory tests. For those tests with a direct analyser equivalent, there was a 9% and 13% reduction in biochemical and haematological tests respectively. However, there was a 46% increase in the total number of biochemical tests ‐ by laboratory or analyser ‐ during the period when analysers were available. No effect on the detection of new disease or the control of existing disease was observed. Patients rated analysers highly and rated laboratory tests less highly when analysers were available. General practitioners typically reported that the analysers made a minor contribution to their practice and did not fit in easily. The level of analytical reliabiiity of the analysers was not always acceptable.Conclusion:General practices varied greatly in their use of the analysers. This experience of dry chemistry pathology in general practice suggests that its application is limited.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb119443.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb119444.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb119445.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb119446.x

出版商:Wiley    

年代:1991

数据来源: WILEY