Objective: To construct useful indices for hospital management, based on descriptive multivariate techniques.
Material And Methods: Data were collected during 1999 and 2000, on hospital admissions occurring during 1997-1998 at Hospital General de Algeciras, part of Servicio Andaluz de Salud (SAS) of Sistema Nacional de Salud Español (Spanish National Health Service). The following variables routinely monitored by health authorities were analyzed: number of admissions, mortality, number of re-admissions, number of outpatient consultations, case-mix index, number of stays, and functional index. Variables were measured in a total of 22486 admissions. We applied the Principal Components Analysis (PCA) method using the R correlation matrix.
Results: The first two components were selected, accounting cumulatively for 62.67% of the variability in the data.
Conclusions: The first component represents a new index representing the number of attended persons, which we have termed Case Load. The second PC represents or explains the difficulty of the attended cases, which we have termed Case Complexity. These two indices are useful to classify hospital services.
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S Afr J Surg
December 2024
Division of Surgery, Tygerberg Hospital, Stellenbosch University, South Africa.
Background: Bowel trauma, encompassing injuries to the small and large intestine, represents a significant medical challenge due to its potential for morbidity and mortality. Management of bowel injuries remains surgical, but multiple factors influence the outcome in these patients. This study provides an in-depth analysis of the high-risk features of hollow visceral trauma in the ICU setting and the corresponding mortality rates, shedding light on the critical factors that influence outcomes in these cases.
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December 2024
Department of Surgical Sciences, Nelson R Mandela School of Clinical Medicine, University of KwaZulu-Natal, South Africa.
Background: KwaZulu-Natal bears a significant trauma burden, with polytrauma patients often experiencing traumatic limb amputations. This study investigates traumatic limb amputations in the subgroup of severely injured polytrauma patients admitted to the trauma ICU in KwaZulu-Natal. This study aims to describe the management and outcomes of traumatic limb amputations in polytrauma patients at the trauma ICU.
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December 2024
Department of Biostatistics, Faculty of Health Sciences, University of the Free State, South Africa.
Background: Postoperative patients' risk for developing venous thromboembolism (VTE) can be predicted using the adapted Caprini risk assessment model which informs administration of postoperative VTE prophylaxis. The study aimed to assess the appropriateness of postoperative VTE prophylaxis of patients according to the adapted Caprini scores and investigate whether a patient's HIV status influenced postoperative VTE prophylaxis administration.
Methods: This cohort study included patients who had elective or urgent surgery at a tertiary hospital, Bloemfontein.
S Afr J Surg
December 2024
Department of Surgery, University of KwaZulu-Natal, South Africa.
Background: This study aimed to assess the contribution of human error to adverse events over 10 years in a single surgical department in South Africa.
Methods: A retrospective database analysis was undertaken to identify all adverse events, which were further assessed to identify which were error-associated.
Results: A total of 14 237 adverse events occurred between December 2012 and January 2023, of which 7 504 (52.
Hypertension
January 2025
Accelerator for Clinical Transformation, Brigham and Women's Hospital, Boston, MA. (S.H., A.J.B., D.Z., S.K., K.W., D.G., C.P.C., B.M.S.).
Background: Hypertension is a major cardiovascular risk factor, yet traditional care often results in suboptimal blood pressure (BP) control at the population level. We implemented a remote hypertension management program that monitored home BP and titrated medications per algorithm. This study assessed the program's long-term effects by examining participants' office BP up to 42 months post-enrollment.
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