OBJECTIVE To compare crude and adjusted in-hospital mortality rates after prostatectomy between hospitals using routinely collected hospital discharge data and to illustrate the value and limitations of using comparative mortality rates as a surrogate measure of quality of care. METHODS Mortality rates for non-teaching hospitals (n = 21) were compared to a single notional group of teaching ho...

With increasing life expectancies, the burden of aortic valve disease continues to be a major contributor to morbidity and mortality, affecting millions of elderly people [1,2]. Aortic stenosis (AS) begins with a long asymptomatic period [3]. Once symptomatic, survival becomes poor unless the outflow obstruction is relieved [4-6]. Retrospective studies have shown that if the patient experiences...

Risk-adjusted hospital-wide mortality has been proposed as a key indicator of system-level quality. Several risk-adjusted measures are available, and one-the hospital standardized mortality ratio (HSMR) - is publicly reported in a number of countries, but not in the United States. This paper reviews potential uses of such measures. We conclude that available methods are not suitable for interho...

BACKGROUND/PURPOSE In-hospital mortality rate of acute ischemic stroke patients remains between 3% and 18%. For improving the quality of stroke care, we investigated the factors that contribute to the risk of in-hospital mortality in acute ischemic stroke patients. MATERIALS AND METHODS Between January 1, 2007, and December 31, 2011, 2,556 acute ischemic stroke patients admitted to a stroke u...

BACKGROUND Acute exacerbations of chronic obstructive pulmonary disease (COPD) are a frequent cause of hospitalization in the United States. Previous studies of selected populations of patients with COPD have estimated in-hospital mortality to range from 4% to 30%. Our objective was to obtain a generalizable estimate of in-hospital mortality from acute exacerbation of COPD in the United States ...

BACKGROUND Recent studies have found substantial variation in hospital resource use by expired Medicare beneficiaries with chronic illnesses. By analyzing only expired patients, these studies cannot identify differences across hospitals in health outcomes like mortality. This study examines the association between mortality and resource use at the hospital level, when all Medicare beneficiaries...

BACKGROUND To document the relationship between triage vital signs and in-hospital mortality among emergency department (ED) patients with acute poisoning. METHODS Poisoning patients who admitted to our emergency department during the study period were enrolled. Patient's demographic data were collected and odds ratios (OR) of triage vital signs to in-hospital mortality were assessed. Receive...

Mortality remains high among patients with pulmonary tuberculosis requiring mechanical ventilation (TBMV). This study was carried out to establish the mortality rates of TBMV and to identify factors that contribute to in-hospital mortality. From January 1996-April 2001, there were 825 patients with active pulmonary tuberculosis at the National Taiwan University Hospital, Taipei, Taiwan. Of thes...

OBJECTIVE We examined the implications of reliability adjustment on hospital mortality with surgery. DATA SOURCE We used national Medicare data (2003-2006) for three surgical procedures: coronary artery bypass grafting (CABG), abdominal aortic aneurysm (AAA) repair, and pancreatic resection. STUDY DESIGN We conducted an observational study to evaluate the impact of reliability adjustment on...

Background and Objective: Due to the importance of acute kidney injury associated in patients with sepsis and the impact of various factors on mortality and hospital stay of these patients, this study was conducted to investigate the clinical features and risk factors for acute kidney injury in patients with sepsis. In addition, we examined whether the severity of acute kidney injury affected c...