Posts by Danielle Scheurer

Publicly reported mortality correlates with overall mortality

This large cohort of hospitals found that those with lower publicly reported mortality (of CHF, AMI, pneumonia) were much more likely to have lower mortality of other medical - surgical conditions. This implies that those publicly reported mortality measures are a good proxy for other conditions in mortality (abstract).

Preventable Medicare spending

This large cohort of Medicare beneficiaries found the top decile of the most costly patients accounted for 33% of total ED costs and 80% of total inpatient costs. About 40% of the ED costs and about 10% of the inpatient costs were found to be preventable. Surprisingly regions with high density of primary care had higher preventable costs for these high cost patients (abstract).

Quitting smoking before surgery

This large analysis from NSQUIP found past smokers (>1 year quit) had similar post-op mortality compared to non-smokers, but current smokers had an odds ratio of post-op mortality of 1.17. Arterial events and respiratory events were higher in past smokers than non-smokers, but still significantly less than current smokers. This data adds to the existing literature of the benefits of smoking cessation before surgical intervention (abstract).

Thrombolytics in stroke; the faster the better

A large analysis from a stroke registry found better outcomes with earlier thrombolytics for acute ischemic stroke; every 15 minutes earlier was associated with an odds ratio of 0.96 for in-hospital death or intracranial hemorrhage, and an odds ratio of 1.03 for being discharged home and 1.04 for walking independently at discharge (abstract).

Mortality higher in late-week elective surgeries

This large cohort of elective surgical patients found those that underwent surgery later in the week or on a weekend had higher 30 day mortality compared to those that underwent surgery earlier in the week. Although uncontrolled confounding may have affected the results, the authors speculate the risk may be higher due to lower staffing on weekends (abstract).