Other bulletins in this series include:

Breast Surgery

Wednesday 11 November 2009

ICU admissions after actual or planned hospital discharge

ICU admissions after actual or planned hospital discharge. Chest, vol. 136(5), Nov. 2009, p.1257-1262.

Chawla, S., et al.

http://chestjournal.chestpubs.org/content/136/5/1257.full

Unexpected ICU admissions may result from early or premature discharge from the hospital. We sought to determine the incidence, clinical characteristics, and outcomes of patients admitted to the ICU after actual or planned hospital discharge and to analyze whether the need for ICU admission was related or unrelated to the associated hospitalization.

Caring to the end?

Caring to the end? National confidential enquiry into patient outcome and death. A review of the care of patients who died in hospital within four days of admission. 2009.

Cooper, H. et al.

http://www.ncepod.org.uk/2009report2/Downloads/DAH_report.pdf

This report highlights the process of care of patients who died in acute hospitals within four days of admission. It takes a critical look at the areas where patient care might have been improved. Remediable factors have been identified in the clinical and the organisational care of these patients.

Prolonged acute mechanical ventilation: implications for hospital benchmarking

Prolonged acute mechanical ventilation: implications for hospital benchmarking. Chest, vol. 135(5), May 2009, p.1157-1162.

Zilberberg, M.D. et al.

http://chestjournal.chestpubs.org/content/135/5/1157.full

Hospital performance measures rely on aggregate outcomes. For patients receiving mechanical ventilation (MV), outcomes depend on severity of illness, hospital MV volume, and case mix. Patients requiring prolonged acute MV (PAMV) [MV for ≥ 96 h] comprise a resource-intensive group, but the impact of its volume on aggregate outcomes is unknown. We investigated whether observed outcomes differed from those predicted by APACHE (acute physiology and chronic health evaluation) IV risk adjustment and the relationship between hospital MV volume and outcomes among patients receiving PAMV.