ISSN:1070-5295    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1070-5295    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1070-5295    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1070-5295    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Cardiac surgery has come under intense scrutiny with public release of “report cards” documenting hospital and physician performance. Preexisting patient condition plays an important role in determining outcome; thus it is essential that crude mortality statistics be adjusted. This review summarizes existing methods of risk-stratification for cardiac surgical outcome reporting and discusses recent relevant literature.

ISSN:1070-5295    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The emphasis of this review is data quality and the statistical performance of seventy models. Assumptions made about missing values, evaluation of reliability, model performance assessment, and model customization are reviewed and discussed. Although performance evaluation methods are well developed, they are not extensively applied. If severity models are not correctly revised and used, the information they produce has very little value.

ISSN:1070-5295    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

To facilitate the development of optimal health policies related to health care delivery in the pediatric intensive care unit (ICU), it is important to measure the outcomes after ICU care. Models for prediction of mortality and functional outcomes have been developed in this setting. Such models have been applied in many clinical, cost-containment, and management studies. Newer severity of illness models have also been proposed that may improve the scope of their application in the pediatric ICU. With the changing and dynamic nature of medical strategies in the pediatric ICU, these models will likely need to be reevaluated over time to meet these changes. Future research should aim at developing comprehensive quality of life models for estimating patient outcomes in the pediatric ICU.

ISSN:1070-5295    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The severity of illness scoring systems in use incorporate both a “case-mix description” and an “outcome prediction” capability. The review of the literature of scoring systems and their role in management and utilization programs of intensive care units has shown that the most relevant research addresses the prediction capability of the researched models. Whereas their description capability seems undisputed, the prediction capability of the scoring systems faces yet unsolved serious methodologic problems. In this review it is contended that the use of the prediction capability of the severity of illness scoring systems cannot replace for the approach of the management and utilization of intensive care units from a scientific managerial perspective, in which “improvement” is the leading keyword. “Improvement” can only be operationalized by enlightened changes of the ways of working and processes of care.

ISSN:1070-5295    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Phase 1 of the SUPPORT study identified serious problems in communication, decision-making, and outcomes in critically ill patients. In Phase 2, a multi-faceted intervention that included presentation of objective prognostic information had minimal beneficial impact. Potential explanations for this observation include: 1) prognostic information in technically complex; 2) prognostic estimates are not much more accurate than experienced clinicians; 3) clinicians have little to no training experience, or incentive for using objective prognostic data; and, 4) such data is more relevant to groups of patients than individuals. Further work is needed to advance the state of the art for prognostic information before we can expect it to have significant impact on patient care.

ISSN:1070-5295    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Many new techniques and pharmacologic strategies are used to decrease ischemia and reperfusion injury following cardiac arrest. These therapies are directed at both the enhancement of cerebral blood flow, resulting in an increase in oxygen delivery to the brain, and at modulating some of the causes of neuronal injury following global ischemia. These therapies include treatment of acidosis, hypothermia, antioxidant drugs, calcium entry blockers, excitatory amino acid antagonists, sodium bicarbonate, and avoidance of hyperglycemia. Supportive care after cardiac arrest, including seizure prophylaxis and intracranial pressure monitoring, are also discussed.

ISSN:1070-5295    

出版商:OVID    

年代:1997

数据来源: OVID