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A 20-year prospective study of mortality and causes of death among hospitalized opioid addicts in Oslo.

https://arctichealth.org/en/permalink/ahliterature87156
Source
BMC Psychiatry. 2008;8:8
Publication Type
Article
Date
2008
Author
Bjornaas Mari A
Bekken Anette S
Ojlert Aasa
Haldorsen Tor
Jacobsen Dag
Rostrup Morten
Ekeberg Oivind
Author Affiliation
Department of Acute Medicine, Ullevaal University Hospital, N-0407 Oslo, Norway. mabjornaas@gmail.com
Source
BMC Psychiatry. 2008;8:8
Date
2008
Language
English
Publication Type
Article
Keywords
Accidents - mortality
Adolescent
Adult
Cause of Death - trends
Cohort Studies
Female
Follow-Up Studies
Hospital Mortality - trends
Humans
Male
Mathematical Computing
Narcotics - poisoning
Neoplasms - mortality
Opioid-Related Disorders - mortality - rehabilitation
Overdose - mortality - prevention & control
Patient Admission - statistics & numerical data
Risk
Street Drugs - poisoning
Suicide - statistics & numerical data
Sweden
Violence - statistics & numerical data
Abstract
BACKGROUND: To study mortality rate and causes of death among all hospitalized opioid addicts treated for self-poisoning or admitted for voluntary detoxification in Oslo between 1980 and 1981, and to compare their mortality to that of the general population. METHODS: A prospective cohort study was conducted on 185 opioid addicts from all medical departments in Oslo who were treated for either self-poisoning (n = 93, 1980), voluntary detoxification (n = 75, 1980/1981) or both (n = 17). Their median age was 24 years; with a range from 16 to 41, and 53% were males. All deaths that had occurred by the end of 2000 were identified from the Central Population Register. Causes of death were obtained from Statistics Norway. Standardized mortality ratios (SMRs) were computed for mortality, in general, and in particular, for different causes of death. RESULTS: During a period of 20 years, 70 opioid addicts died (37.8%), with a standardized mortality ratio (SMR) equal to 23.6 (95% CI, 18.7-29.9). The SMR remained high during the whole period, ranging from 32.4 in the first five-year period, to 13.4 in the last five-year period. There were no significant differences in SMR between self-poisonings and those admitted for voluntarily detoxification. The registered causes of death were accidents (11.4%), suicide (7.1%), cancer (4.3%), cardiovascular disease (2.9%), other violent deaths (2.9%), other diseases (71.4%). Among the 50 deaths classified as other diseases, the category "drug dependence" was listed in the vast majority of cases (37 deaths, 52.9% of the total). SMRs increased significantly for all causes of death, with the other diseases group having the highest SMR; 65.8 (95% CI, 49.9-86.9). The SMR was 5.4 (95% CI, 1.3-21.5) for cardiovascular diseases, and 4.3 (95% CI, 1.4-13.5) for cancer. The SMR was 13.2 (95% CI, 6.6-26.4) for accidents, 10.7 (95% CI, 4.5-25.8) for suicides, and 28.6 (95% CI, 7.1-114.4) for other violent deaths. CONCLUSION: The risk of death among opioid addicts was significantly higher for all causes of death compared with the general population, implying a poor prognosis over a 20-year period for this young patient group.
PubMed ID
18271956 View in PubMed
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30-Day Survival Probabilities as a Quality Indicator for Norwegian Hospitals: Data Management and Analysis.

https://arctichealth.org/en/permalink/ahliterature273361
Source
PLoS One. 2015;10(9):e0136547
Publication Type
Article
Date
2015
Author
Sahar Hassani
Anja Schou Lindman
Doris Tove Kristoffersen
Oliver Tomic
Jon Helgeland
Source
PLoS One. 2015;10(9):e0136547
Date
2015
Language
English
Publication Type
Article
Keywords
Comorbidity
Diagnosis-Related Groups
Episode of Care
Hospital Mortality
Hospital records
Hospitals - standards - statistics & numerical data
Humans
Length of Stay
Norway - epidemiology
Patient Admission - statistics & numerical data
Patient Discharge - statistics & numerical data
Patient transfer
Probability
Quality Improvement
Quality Indicators, Health Care
Survival Analysis
Abstract
The Norwegian Knowledge Centre for the Health Services (NOKC) reports 30-day survival as a quality indicator for Norwegian hospitals. The indicators have been published annually since 2011 on the website of the Norwegian Directorate of Health (www.helsenorge.no), as part of the Norwegian Quality Indicator System authorized by the Ministry of Health. Openness regarding calculation of quality indicators is important, as it provides the opportunity to critically review and discuss the method. The purpose of this article is to describe the data collection, data pre-processing, and data analyses, as carried out by NOKC, for the calculation of 30-day risk-adjusted survival probability as a quality indicator.
Three diagnosis-specific 30-day survival indicators (first time acute myocardial infarction (AMI), stroke and hip fracture) are estimated based on all-cause deaths, occurring in-hospital or out-of-hospital, within 30 days counting from the first day of hospitalization. Furthermore, a hospital-wide (i.e. overall) 30-day survival indicator is calculated. Patient administrative data from all Norwegian hospitals and information from the Norwegian Population Register are retrieved annually, and linked to datasets for previous years. The outcome (alive/death within 30 days) is attributed to every hospital by the fraction of time spent in each hospital. A logistic regression followed by a hierarchical Bayesian analysis is used for the estimation of risk-adjusted survival probabilities. A multiple testing procedure with a false discovery rate of 5% is used to identify hospitals, hospital trusts and regional health authorities with significantly higher/lower survival than the reference. In addition, estimated risk-adjusted survival probabilities are published per hospital, hospital trust and regional health authority. The variation in risk-adjusted survival probabilities across hospitals for AMI shows a decreasing trend over time: estimated survival probabilities for AMI in 2011 varied from 80.6% (in the hospital with lowest estimated survival) to 91.7% (in the hospital with highest estimated survival), whereas it ranged from 83.8% to 91.2% in 2013.
Since 2011, several hospitals and hospital trusts have initiated quality improvement projects, and some of the hospitals have improved the survival over these years. Public reporting of survival/mortality indicators are increasingly being used as quality measures of health care systems. Openness regarding the methods used to calculate the indicators are important, as it provides the opportunity of critically reviewing and discussing the methods in the literature. In this way, the methods employed for establishing the indicators may be improved.
Notes
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PubMed ID
26352600 View in PubMed
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[Abdominal aortic aneurysm at a county hospital].

https://arctichealth.org/en/permalink/ahliterature218599
Source
Tidsskr Nor Laegeforen. 1994 Mar 10;114(7):790-2
Publication Type
Article
Date
Mar-10-1994
Author
H. Espelid
O. Vennesland
H J Rossebø
Author Affiliation
Kirurgisk avdeling, Fylkessjukehuset i Haugesund.
Source
Tidsskr Nor Laegeforen. 1994 Mar 10;114(7):790-2
Date
Mar-10-1994
Language
Norwegian
Publication Type
Article
Keywords
Aged
Aortic Aneurysm, Abdominal - mortality - surgery
Emergencies
Female
Hospital Mortality
Hospitals, County - statistics & numerical data
Humans
Intraoperative Complications - mortality
Male
Middle Aged
Norway - epidemiology
Postoperative Complications - mortality
Prognosis
Abstract
During the period January 1985 to May 1993, 129 patients were hospitalized for abdominal aortic aneurysms at the hospital in Haugesund. Of these patients, 93 underwent surgery at our hospital. Acute operations were performed in 33 patients with a perioperative (30 days) mortality of 45%. 60 patients underwent elective surgery with no perioperative (30 days) mortality. 14 patients were sent to a regional/university hospital. For various reasons, 22 patients were not operated on.
PubMed ID
8009496 View in PubMed
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Abdominal injuries in a low trauma volume hospital--a descriptive study from northern Sweden.

https://arctichealth.org/en/permalink/ahliterature264480
Source
Scand J Trauma Resusc Emerg Med. 2014;22:48
Publication Type
Article
Date
2014
Author
Patrik Pekkari
Per-Olof Bylund
Hans Lindgren
Mikael Öman
Source
Scand J Trauma Resusc Emerg Med. 2014;22:48
Date
2014
Language
English
Publication Type
Article
Keywords
Abdominal Injuries - diagnosis - epidemiology - therapy
Adolescent
Adult
Disease Management
Female
Follow-Up Studies
Hospital Mortality - trends
Hospitals, Low-Volume - statistics & numerical data
Humans
Incidence
Injury Severity Score
Length of Stay - trends
Male
Middle Aged
Prognosis
Retrospective Studies
Survival Rate - trends
Sweden - epidemiology
Tomography, X-Ray Computed
Trauma Centers - statistics & numerical data
Young Adult
Abstract
Abdominal injuries occur relatively infrequently during trauma, and they rarely require surgical intervention. In this era of non-operative management of abdominal injuries, surgeons are seldom exposed to these patients. Consequently, surgeons may misinterpret the mechanism of injury, underestimate symptoms and radiologic findings, and delay definite treatment. Here, we determined the incidence, diagnosis, and treatment of traumatic abdominal injuries at our hospital to provide a basis for identifying potential hazards in non-operative management of patients with these injuries in a low trauma volume hospital.
This retrospective study included prehospital and in-hospital assessments of 110 patients that received 147 abdominal injuries from an isolated abdominal trauma (n = 70 patients) or during multiple trauma (n = 40 patients). Patients were primarily treated at the University Hospital of Umeå from January 2000 to December 2009.
The median New Injury Severity Score was 9 (range: 1-57) for 147 abdominal injuries. Most patients (94%) received computed tomography (CT), but only 38% of patients with multiple trauma were diagnosed with CT
Notes
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Cites: J Surg Educ. 2013 Sep-Oct;70(5):618-2724016373
PubMed ID
25124882 View in PubMed
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The ability to achieve complete revascularization is associated with improved in-hospital survival in cardiogenic shock due to myocardial infarction: Manitoba cardiogenic SHOCK Registry investigators.

https://arctichealth.org/en/permalink/ahliterature134718
Source
Catheter Cardiovasc Interv. 2011 Oct 1;78(4):540-8
Publication Type
Article
Date
Oct-1-2011
Author
Farrukh Hussain
Roger K Philipp
Robin A Ducas
Jason Elliott
Vladimír D┼żavík
Davinder S Jassal
James W Tam
Daniel Roberts
Philip J Garber
John Ducas
Author Affiliation
Section of Cardiology Dept. of Cardiac Sciences, University of Manitoba, Winnipeg, Manitoba, Canada. fhussain@sbgh.mb.ca
Source
Catheter Cardiovasc Interv. 2011 Oct 1;78(4):540-8
Date
Oct-1-2011
Language
English
Publication Type
Article
Keywords
Aged
Angioplasty, Balloon, Coronary - adverse effects - mortality
Cardiovascular Agents - adverse effects - therapeutic use
Catheterization, Swan-Ganz
Coronary Angiography
Coronary Artery Bypass - adverse effects - mortality
Female
Hospital Mortality
Humans
Logistic Models
Male
Manitoba
Middle Aged
Myocardial Infarction - complications - diagnosis - mortality - therapy
Odds Ratio
Patient Discharge - statistics & numerical data
Registries
Retrospective Studies
Risk assessment
Risk factors
Shock, Cardiogenic - diagnosis - etiology - mortality - therapy
Survival Analysis
Survival Rate
Time Factors
Treatment Outcome
Abstract
To identify predictors of survival in a retrospective multicentre cohort of patients with cardiogenic shock undergoing coronary angiography and to address whether complete revascularization is associated with improved survival in this cohort.
Early revascularization is the standard of care for cardiogenic shock. Coronary bypass grafting and percutaneous intervention have complimentary roles in achieving this revascularization.
A total of 210 consecutive patients (mean age 66 ± 12 years) at two tertiary centres from 2002 to 2006 inclusive with a diagnosis of cardiogenic shock were evaluated. Univariate and multivariate predictors of in-hospital survival were identified utilizing logistic regression.
ST elevation infarction occurred in 67% of patients. Thrombolysis was administered in 34%, PCI was attempted in 62% (88% stented, 76% TIMI 3 flow), CABG was performed in 22% (2.7 grafts, 14 valve procedures), and medical therapy alone was administered to the remainder. The overall survival to discharge was 59% (CABG 68%, PCI 57%, medical 48%). Independent predictors of mortality included complete revascularization (P = 0.013, OR = 0.26 (95% CI: 0.09-0.76), hyperlactatemia (P = 0.046, OR = 1.14 (95% CI: 1.002-1.3) per mmol increase), baseline renal insufficiency (P = 0.043, OR = 3.45, (95% CI: 1.04-11.4), and the presence of anoxic brain injury (P = 0.008, OR = 8.22 (95% CI: 1.73-39.1). Within the STEMI with concomitant multivessel coronary disease subgroup of this population (N = 101), independent predictors of survival to discharge included complete revascularization (P = 0.03, OR = 2.5 (95% CI: 1.1-6.2)) and peak lactate (P = 0.02).
The ability to achieve complete revascularization may be strongly associated with improved in-hospital survival in patients with cardiogenic shock.
Notes
Comment In: Catheter Cardiovasc Interv. 2011 Oct 1;78(4):549-5021953751
PubMed ID
21547996 View in PubMed
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Abnormal vital signs are strong predictors for intensive care unit admission and in-hospital mortality in adults triaged in the emergency department - a prospective cohort study.

https://arctichealth.org/en/permalink/ahliterature125355
Source
Scand J Trauma Resusc Emerg Med. 2012;20:28
Publication Type
Article
Date
2012
Author
Charlotte Barfod
Marlene Mauson Pankoke Lauritzen
Jakob Klim Danker
György Sölétormos
Jakob Lundager Forberg
Peter Anthony Berlac
Freddy Lippert
Lars Hyldborg Lundstrøm
Kristian Antonsen
Kai Henrik Wiborg Lange
Author Affiliation
Department of Anaesthesia and Intensive Care, Hillerød Hospital, Denmark. cbar@hih.regionh.dk
Source
Scand J Trauma Resusc Emerg Med. 2012;20:28
Date
2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Denmark
Emergency Service, Hospital - statistics & numerical data
Female
Hospital Mortality
Humans
Intensive Care Units - statistics & numerical data
Male
Middle Aged
Outcome and Process Assessment (Health Care)
Patient Admission - statistics & numerical data
Prognosis
Prospective Studies
Regression Analysis
Triage - methods - statistics & numerical data
Vital Signs
Young Adult
Abstract
Assessment and treatment of the acutely ill patient have improved by introducing systematic assessment and accelerated protocols for specific patient groups. Triage systems are widely used, but few studies have investigated the ability of the triage systems in predicting outcome in the unselected acute population. The aim of this study was to quantify the association between the main component of the Hillerød Acute Process Triage (HAPT) system and the outcome measures; Admission to Intensive Care Unit (ICU) and in-hospital mortality, and to identify the vital signs, scored and categorized at admission, that are most strongly associated with the outcome measures.
The HAPT system is a minor modification of the Swedish Adaptive Process Triage (ADAPT) and ranks patients into five level colour-coded triage categories. Each patient is assigned a triage category for the two main descriptors; vital signs, T(vitals), and presenting complaint, T(complaint). The more urgent of the two determines the final triage category, T(final). We retrieved 6279 unique adult patients admitted through the Emergency Department (ED) from the Acute Admission Database. We performed regression analysis to evaluate the association between the covariates and the outcome measures.
The covariates, T(vitals), T(complaint) and T(final) were all significantly associated with ICU admission and in-hospital mortality, the odds increasing with the urgency of the triage category. The vital signs best predicting in-hospital mortality were saturation of peripheral oxygen (SpO(2)), respiratory rate (RR), systolic blood pressure (BP) and Glasgow Coma Score (GCS). Not only the type, but also the number of abnormal vital signs, were predictive for adverse outcome. The presenting complaints associated with the highest in-hospital mortality were 'dyspnoea' (11.5%) and 'altered level of consciousness' (10.6%). More than half of the patients had a T(complaint) more urgent than T(vitals), the opposite was true in just 6% of the patients.
The HAPT system is valid in terms of predicting in-hospital mortality and ICU admission in the adult acute population. Abnormal vital signs are strongly associated with adverse outcome, while including the presenting complaint in the triage model may result in over-triage.
Notes
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PubMed ID
22490208 View in PubMed
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Absolute vs relative improvements in congenital diaphragmatic hernia survival: what happened to "hidden mortality".

https://arctichealth.org/en/permalink/ahliterature151056
Source
J Pediatr Surg. 2009 May;44(5):877-82
Publication Type
Article
Date
May-2009
Author
V Kandice Mah
Mohammed Zamakhshary
Doug Y Mah
Brian Cameron
Juan Bass
Desmond Bohn
Leslie Scott
Sharifa Himidan
Mark Walker
Peter C W Kim
Author Affiliation
Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
Source
J Pediatr Surg. 2009 May;44(5):877-82
Date
May-2009
Language
English
Publication Type
Article
Keywords
Cohort Studies
Death Certificates
Female
Fetal Death - epidemiology
Fetal Diseases - surgery
Hernia, Diaphragmatic - congenital - embryology - mortality - surgery
Hospital Mortality
Hospitals, Pediatric - statistics & numerical data
Humans
Infant, Newborn
Male
Ontario - epidemiology
Selection Bias
Stillbirth - epidemiology
Survival Analysis
Abstract
The aim of this study is to determine if there has been a true, absolute, or apparent relative increase in congenital diaphragmatic hernia (CDH) survival for the last 2 decades.
All neonatal Bochdalek CDH patients admitted to an Ontario pediatric surgical hospital during the period when significant improvements in CDH survival was reported (from January 1, 1992, to December 31, 1999) were analyzed. Patient characteristics were assessed for CDH population homogeneity and differences between institutional and vital statistics-based population survival outcomes. SAS 9.1 (SAS Institute, Cary, NC) was used for analysis.
Of 198 cohorts, demographic parameters including birth weight, gestational age, Apgar scores, sex, and associated congenital anomalies did not change significantly. Preoperative survival was 149 (75.2%) of 198, whereas postoperative survival was 133 (89.3%) of 149, and overall institutional survival was 133 (67.2%) of 198. Comparison of institution and population-based mortality (n = 65 vs 96) during the period yielded 32% of CDH deaths unaccounted for by institutions. Yearly analysis of hidden mortality consistently showed a significantly lower mortality in institution-based reporting than population.
A hidden mortality exists for institutionally reported CDH survival rates. Careful interpretation of research findings and more comprehensive population-based tools are needed for reliable counseling and evaluation of current and future treatments.
PubMed ID
19433161 View in PubMed
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[Abuse of data from registries 1. Uncertain data on infarction, results are exaggerated]

https://arctichealth.org/en/permalink/ahliterature54591
Source
Lakartidningen. 1996 Dec 11;93(50):4620-2
Publication Type
Article
Date
Dec-11-1996
Author
A. Taube
Author Affiliation
Statistiska institutionen, Uppsala universitet.
Source
Lakartidningen. 1996 Dec 11;93(50):4620-2
Date
Dec-11-1996
Language
Swedish
Publication Type
Article
Keywords
Health Policy
Hospital Mortality
Humans
Myocardial Infarction - metabolism
Registries - standards
Sweden - epidemiology
PubMed ID
8999255 View in PubMed
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[Abuse of registry data 2. Thirteen surgeons work with statistical sections]

https://arctichealth.org/en/permalink/ahliterature22238
Source
Lakartidningen. 1997 Jan 8;94(1-2):61-2
Publication Type
Article
Date
Jan-8-1997
Author
A. Taube
Author Affiliation
Statistiska institutionen, Uppsala Universitet.
Source
Lakartidningen. 1997 Jan 8;94(1-2):61-2
Date
Jan-8-1997
Language
Swedish
Publication Type
Article
Keywords
Hospital Mortality
Humans
Models, Statistical
Pancreatic Neoplasms - mortality
Registries - standards
Sweden - epidemiology
PubMed ID
9053609 View in PubMed
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Acceptable long-term outcome in elderly intensive care unit patients.

https://arctichealth.org/en/permalink/ahliterature133259
Source
Dan Med Bull. 2011 Jul;58(7):A4297
Publication Type
Article
Date
Jul-2011
Author
Morten A Schrøder
Jesper Brøndum Poulsen
Anders Perner
Author Affiliation
Intensive Care Unit, 4131, Rigshospitalet, Blegdamsvej 9, 2100 København Ø, Denmark. mortenschroder@gmail.com
Source
Dan Med Bull. 2011 Jul;58(7):A4297
Date
Jul-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Confidence Intervals
Denmark
Female
Hospital Mortality - trends
Humans
Intensive Care Units - statistics & numerical data
Male
Mental health
Middle Aged
Outcome Assessment (Health Care)
Prospective Studies
Quality of Life
Questionnaires
Registries
Statistics, nonparametric
Survivors
Time Factors
Treatment Outcome
Young Adult
Abstract
The number of elderly intensive care unit (ICU) patients is increasing. We therefore assessed the long-term outcome in the elderly following intensive care.
The outcome status for 91 elderly (=75 years) and 659 nonelderly (18-74 years) ICU patients treated in the course of a one year period was obtained. A total of 36 of 37 eligible elderly survivors were interviewed about their health related quality of life (HRQOL), social services and their wish for intensive care.
The mortality (54% at follow-up and 64% after one year) was higher in the elderly ICU patients than in non-elderly ICU patients (33% and 37%, respectively, p
PubMed ID
21722543 View in PubMed
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1274 records – page 1 of 128.