Abstract：
BACKGROUND:Our ability to maintain satisfactory levels of outcome after elective abdominal aortic aneurysm (AAA) surgery is increasingly strained by rising levels of co-morbidity in the presenting population. In this study we present a comparative outcome analysis of patients undergoing elective AAA surgery 18 months before and after the establishment of a surgical high dependency unit (HDU). METHODS:The preoperative status (ASA and POSSUM scores), operative factors and postoperative outcomes as well as duration of stay were calculated for 104 patients undergoing elective AAA repair (57 prior to the HDU opening and 47 patients afterwards). RESULTS:Patients undergoing surgery in the latter period had significantly higher ASA (2.5 +/- 0.06 versus 2.7 +/- 0.7; p = 0.007), overall POSSUM (33.2 +/- 0.5 versus 35.5 +/- 0.8; p = 0.02) and physiological POSSUM (16.3 +/- 0.3 versus 15.5 +/- 0.2; p = 0.048) scores than those operated on prior to establishment of the HDU (data are mean +/- SEM; 2-tailed p-score). The two groups had similar total lengths of hospital stay (518 versus 534 days). However, following establishment of the HDU patients occupied fewer ICU bed days (110 versus 181). This resulted in a saving of Euro 50,750. CONCLUSION:The efficiency and quality of care following elective AAA surgery can be improved by provision of HDU step-down facilities without significantly increased expenditure.
journal_name
Ir J Med Scijournal_title
Irish journal of medical scienceauthors
Cleary M,Cahill RA,Younis F,Sheehan SJ,Mehigan D,Barry MCdoi
10.1007/BF03169165subject
Has Abstractpub_date
2006-07-01 00:00:00pages
9-12issue
3eissn
0021-1265issn
1863-4362journal_volume
175pub_type
杂志文章abstract：BACKGROUND:It has been recognised for some time that mortality rates vary across social class groups, with lower rates in the higher social classes. Internationally, but particularly in Ireland, many studies on the topic of inequalities in mortality have been confined to men, partly because the most frequently used soc...
journal_title：Irish journal of medical science
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更新日期：2015-09-01 00:00:00
abstract：INTRODUCTION:Optimisation of patient comfort during flexible bronchoscopy is achieved with the use of intravenous sedation and vocal anaesthesia. METHODS:The effect of transcricoid lignocaine injection was investigated with regards to ease of procedure and frequency of cough. A single-blinded study was carried out and...
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更新日期：2015-06-01 00:00:00
abstract：:The aim of this paper is to assess the adequacy of the diet of individuals over 60 yr of age, participating in the 1990 Irish National Nutritional Survey. A nationwide random sample based on the most recently updated electoral register was used. Demographic information was collected. Anthropometric measurements were t...
journal_title：Irish journal of medical science
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更新日期：1997-10-01 00:00:00
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更新日期：2017-02-01 00:00:00
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journal_title：Irish journal of medical science
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更新日期：1990-02-01 00:00:00
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journal_title：Irish journal of medical science
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更新日期：1998-01-01 00:00:00
abstract：:Preparing a medical school for institutional review can be a challenging undertaking for any institution requiring an understanding of the international standards being used and adequate preparation and planning (MacCarrick et al. in Med Teach 32(5):e227-e232, 2010). This series examines each of the nine standards dev...
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更新日期：1979-12-01 00:00:00
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