Disease relevance of Hospital Mortality

• Two searchers identified all cohort studies or clinical trials reporting in-hospital mortality or rates of congestive heart failure after myocardial infarction in relation to glucose concentration on admission [1].
• Multivariate testing of preoperative and operative descriptors identified radiographic cardiac enlargement, preoperative paced rhythm or atrial fibrillation, 70% or more left main coronary obstruction, and serum bilirubin of more than 2 mg% as factors associated with an increase in in-hospital mortality [2].
• Of 38 clinical parameters evaluated, multivariate analysis revealed that the three variables contributing the most independent information toward predicting in-hospital mortality were the absence of a history of fever, an elevated serum creatinine and marked leukocytosis [3].
• RESULTS: Hospital mortality was significantly higher among diabetics treated with sulfonylurea drugs at the time of myocardial infarction (24% vs. 11%) [4].
• Multidrug resistance, extrapulmonary disease, and HIV infection were unexpectedly not related to in-hospital mortality [5].

Psychiatry related information on Hospital Mortality

• Factors associated with increased in-hospital mortality ("the deadly triad") should be identified and taken into consideration for risk stratification and decision-making [6].

High impact information on Hospital Mortality

• The in-hospital mortality rates in the t-PA and PTCA groups were 6.5 and 2.6 percent, respectively (P = 0.06) [7].
• CONCLUSIONS--Patients with COPD admitted to an ICU for an acute exacerbation have a substantial hospital mortality (24%) [8].
• The relation between hospital experience and in-hospital mortality for patients with AIDS-related PCP [9].
• INTERPRETATION: The early use of NIV for mildly and moderately acidotic patients with COPD in the general ward setting leads to more rapid improvement of physiological variables, a reduction in the need for invasive mechanical ventilation (with objective criteria), and a reduction in in-hospital mortality [10].
• In-hospital mortality for QMV, MVR, and MVP was 1, 0, and 0 patients, respectively, and thoracotomy had to be performed again in 1, 1, and 2 patients, respectively (these outcomes were not valve related) [11].

Chemical compound and disease context of Hospital Mortality

• Whereas it was high in those without metformin accumulation (only 1 of 4 patients recovered), early hospital mortality was low in the 10 patients with metformin accumulation and was not related to its extent (3 patients died with end-stage hepatic failure or cardiac failure) [12].
• RESULTS: Age >65 years, temperature <37 degrees C, respiratory rate >24 breaths/min, mental confusion, urea concentration of >7 mmol/l, sodium concentration of <135 mmol/l, and the presence of a pleural effusion, all determined on admission, were independently associated with in-hospital mortality on multivariate analysis [13].
• The primary outcome measure was the in-hospital mortality; secondary end points were the clinical outcome of the infections and the occurrence of colistin toxicity [14].
• CONCLUSIONS: Restriction of third-generation cephalosporin use may improve the antibiotic susceptibility and reduce infection-related hospital mortality in critically ill patients [15].
• CONCLUSION: Oxygen delivery 6 h after oesophagectomy correlates with postoperative complications and may be a determinant of hospital mortality [16].

Biological context of Hospital Mortality

• The absence of a raised hospital mortality in this recent series may be attributed to improved surgical techniques and materials, while the use of droperidol and pentolinium which may reduce pulmonary vascular resistance as well as systemic resistance during surgery could be contributory [17].
• The purpose of this study was to determine if minimum intraoperative hematocrit, maximum glucose concentration, mean arterial pressure on cardiopulmonary bypass, or duration of bypass influence risk-adjusted in-hospital mortality after CABG [18].
• Intraoperative physiologic variables and outcome in cardiac surgery: Part I. In-hospital mortality [18].
• Analysis included age, gender, Injury Severity Score, Glasgow Coma Scale, admission blood pressure, injury complexity, surgical interventions, intensive care and hospital lengths of stay, in-hospital mortality, and disposition [19].
• Multivariate analysis showed that in-hospital mortality was associated with marbleization (mottling) odd-ratio (OR) = 9.0), low diuresis (OR = 4.0), high breath rate 6 hours after admission (OR = 4.0), and chronic digoxin use (OR = 3.39) [20].

Anatomical context of Hospital Mortality

• CONCLUSIONS: Hemodynamic perturbations after protamine administration are independently related to in-hospital mortality after primary coronary artery bypass surgery; the relation is present even in the lowest observed range of values for both systemic hypotension and pulmonary hypertension [21].
• Hospital mortality was 0.46% (2/430) in the mitral valve group while there was no hospital mortality in atrial septal defect group [22].
• We believe aortic valve replacement and open mitral valvotomy is a worthy alternative to double valve replacement in view of its zero hospital mortality, low late mortality, low incidence of restenosis, low thromboembolic episodes and the avoidance of coumarin anticoagulation [23].
• Risk factors for in-hospital mortality were the total extent of akinetic myocardium (p=0.027) in the 30 degrees RAO view and the duration of cardiopulmonary bypass (CPB, p=0.0068) which was itself dependent on the LV ejection fraction (p=0.001), the number of stenosed coronary arteries (p=0.004), and the extent of akinesis (p=0.023) [24].

Associations of Hospital Mortality with chemical compounds

• Mediastinal drainage was slightly higher (p = 0.04) in the aspirin plus dipyridamole group (713 +/- 456 ml) than in the other two groups (placebo, 670 +/- 437 ml; aspirin, 629 +/- 337 ml), but hospital mortality (average, 4.6%) and early reoperation (average, 3.9%) rates were similar among the three groups [25].
• The hospital mortality rate was 12% (3/25) in the terlipressin group and 32% (8/25) in the control group [26].
• Acute physiology, age, chronic health evaluation III score, and cortisol increment were independent factors to predict hospital mortality [27].
• PATIENTS AND METHODS: Derivation-validation set methods were used in 1,826 consecutive patients undergoing coronary intervention with evaluation of baseline creatinine clearance (CrCl), diabetic status, contrast exposure, postprocedure creatinine, ARF, ARFD, in-hospital mortality, and long-term survival (derivation set) [28].
• A maximal arterial lactate concentration of more than 2.2 mM was significantly associated with hospital mortality [29].

Gene context of Hospital Mortality

• Elevated MYO significantly predicted in-hospital mortality (OR 25, 95% CI 1.3-474.2), while increased cTnT concentration did not affect the survival [30].
• Subjects with a shortened activated partial thromboplastin time show increased in-hospital mortality associated with elevated D-dimer, C-reactive protein and glucose levels [31].
• Ultimate hospital mortality was 9/33 (27.3%) in the +Fn group versus 13/34 (38.2%) in the -Fn group (p = 0.244, Fisher's exact test) [32].
• Hospital mortality was statistically greater for patients with bloodstream infections due to P aeruginosa (n = 49) compared to methicillin-sensitive S aureus (MSSA) [n = 117; 30.6% vs 16.2%, p = 0.036] and methicillin-resistant S aureus (MRSA) [n = 148; 30.6% vs 13.5%, p = 0.007] [33].
• The low hospital mortality and encouraging early follow-up data represent a significant improvement over atrial level repairs, supporting the arterial switch operation as the procedure of choice for children who have transposition of the great arteries with ventricular septal defect or double outlet ventricle [34].

Analytical, diagnostic and therapeutic context of Hospital Mortality

• SUMMARY BACKGROUND DATA: In recent years, hepatectomy has been performed with a mortality rate of <10% in patients with HCC, but a zero hospital mortality rate in a large patient series has never been reported [35].
• Overall, in-hospital mortality was 18.0%, and there was no significant difference between those who had coronary angiography on the day of surgery compared with those who had not (No: 16%, n = 81 vs. Yes: 22%, n = 41, p = 0.46) [36].
• Total parenteral nutrition, including fish oil (mean, 0.11 g.kg(-1).day(-1)), was administered for 8.7 +/- 7.5 days and lowered hospital mortality as predicted by Simplified Acute Physiology Score II from 18.9% (95% confidence interval, 17.4-20.4%) to 12.0% (p < .001) [37].
• Patients with nephritis also had lower risks of in-hospital mortality if they were hospitalized at highly experienced hospitals, but this risk did not differ in subgroups with other SLE manifestations or subgroups with different principal reasons for hospitalization [38].
• Intensive management of blood glucose levels was reflected in a 43% reduction in intensive care mortality risk (P=0.036 after correction for interim analyses) and a 34% reduction in hospital mortality (P=0.01) [39].

References