Short-stay carotid endarterectomy is safe and cost-effective.

Background: Carotid endarterectomy (CEA) is conventionally performed following a contrast arteriogram, under general anesthesia, and with postoperative admission to an intensive care unit (ICU). We investigated whether any of these traditional adjuncts to CEA is necessary.

Patients And Methods: Eighteen consecutive patients had CEA performed according to a protocol of duplex scanning only, operation under regional anesthesia, and admission to the ICU only in cases of a proven need for services unique to the ICU (group I).

Case study in physician profiling.

In this article sustained and significant patient day reductions were accomplished over a short period of time with low capital investment. Using an education focus and concentrating on attempting to rationalize observed ranges of physician-resource use across peers, the hospital was able to reduce the length of stay by .5 days in a one-year period.

Carotid endarterectomy in a community hospital: a change in physicians' practice patterns.

A total of 243 consecutive carotid endarterectomies (CEA) performed at Providence Medical Center in Portland, Oregon, were retrospectively reviewed over a 22-month period. Of these, 137 patients (56%) underwent CEA for asymptomatic disease, 52 (37%) of whom had stenotic lesions of 79% or less. There were 6 deaths (3%) and 12 strokes (5%).

Effectiveness of implementing a trauma triage system on outcome: a prospective evaluation.

A 9-month prospective study was conducted in Salt Lake County to evaluate the efficacy of a field trauma triage system using the CRAMS score. Before the triage system was implemented trauma victims were taken to the nearest appropriate hospital. Post-implementation, trauma victims with field CRAMS scores of 1 through 6 were triaged to the Level I Trauma Center.