September 25th, 2011 by Toni Brayer, M.D. in Health Policy
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I spent the day today with 60 physicians and nurses at a symposium focused on quality improvement and reducing mortality from sepsis. Sepsis (overwhelming infection) is the number 1 cause of hospital deaths and the mortality rate can be as high as 60% if the patient goes into shock from infection. Survival depends upon thousands of independent pieces coming together in an organized way. A patient doesn’t come to the emergency department and say “I have sepsis”. He may arrive by ambulance or be brought in by a relative and simply feel weak, or confused or have a fever.
To make the diagnosis, the doctor or nurse has to be thinking sepsis is a possibility and it is critical to get the right tests and treatments within a very short time frame. There are complicated steps that must be taken quickly and the entire hospital team (lab, pharmacy, transport, doctors and nurses) must act Read more »
*This blog post was originally published at EverythingHealth*
July 7th, 2011 by RyanDuBosar in Research
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Obesity is filling in for smoking as a cause of death in working class women, concluded researchers after reviewing mortality rates from a nearly 30-year study in Scotland.
In Europe, wealthier people either aren’t starting to smoke or are finding it easier to quit, which accounts for up to 85% of the observed differences in mortality between population groups, researchers noted.
Their analysis showed higher rates of being overweight or obese among those who’d never smoked in all occupational classes, with the highest rates in women from lower occupational classes. Almost 70% of the women in the lower occupational classes who had never smoked were overweight or obese, and severe obesity was seven times more prevalent than among smokers in higher social positions. Among women who had never smoked, lower social position was associated with higher mortality rates from cardiovascular disease but not cancer.
To investigate the relations between causes of death, social position and obesity in women who had never smoked, Scottish researchers conducted a prospective cohort study. They drew from the Renfrew and Paisley Study, a long term prospective community based cohort named for two neighboring towns in west central Scotland from which all residents then aged between 45 and 64 were invited to participate from 1972 to 1976.
Researchers reported their results online Read more »
*This blog post was originally published at ACP Internist*
July 7th, 2011 by admin in Research
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Nearly forty years ago, President Richard Nixon famously declared a “War on Cancer” by signing the National Cancer Act of 1971. Like the Manhattan Project, the Apollo program that was then landing men on the Moon, and the ongoing (and eventually successful) World Health Organization-led initiative to eradicate smallpox from the face of the Earth, the “War on Cancer” was envisioned as a massive, all-out research and treatment effort. We would bomb cancer into submission with powerful regimens of chemotherapy, experts promised, or, failing that, we would invest in early detection of cancers so that they could be more easily cured at earlier stages.
It was in the spirit of the latter that the National Cancer Institute launched the Prostate, Lung, Colorectal, and Ovarian Cancer (PLCO) Screening trial in 1992. This massive study, which eventually enrolled more than 150,000 men and women between age 55 and 74, was designed to test the widespread belief that screening and early detection of the most common cancers could improve morbidity and mortality in the long term. Not a few influential voices suggested that the many millions of dollars invested in running the trial might be better spent on programs to increase the use of these obviously-effective tests in clinical practice.
They were wrong. As of now, the PLCO study is 0-for-2. Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
May 9th, 2011 by RyanDuBosar in News, Research
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One-third (33.5%) of female heart attack patients receive surgery or angioplasty compared to nearly half (45.6%) of men, and among heart attack patients receiving an intervention such as coronary bypass surgery or angioplasty, women had a 30% higher death rate compared to men, reports HealthGrades.
The findings are based on an analysis of more than 5 million Medicare patient records from 2007 to 2009 and focused on 16 of the most common procedures and diagnoses among women.
The most noticeable disparities were in cardiovascular care. Heart disease is the #1 killer of women in America, surpassing all forms of cancer combined, the company said in a press release. Read more »
*This blog post was originally published at ACP Internist*
March 29th, 2011 by AnneHansonMD in Opinion, Research
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I briefly scanned the Robert Wood Johnson synthesis report on mental and medical co-morbidity so I thought I’d summarize the highlights for the blog. If you’d rather watch the recorded web seminar you can hear it here.
The report relied on systemic literature review to look at the relative risk and mortality associated with co-morbid medical and mental health conditions. The looked at studies using structure clinical interviews, self-report, screening instruments and health care utilization data (diagnostic codes reported to Medicaid).
This is what they found:
- 68 percent of adults with a mental disorder had at least one general medical condition, and 29 percent of those with a medical disorder had a comorbid mental health condition
- These findings support the conclusion that there should be strong integration of medical and mental health care Read more »
*This blog post was originally published at Shrink Rap*
I spent the day today with 60 physicians and nurses at a symposium focused on quality improvement and reducing mortality from sepsis. Sepsis (overwhelming infection) is the number 1 cause of hospital deaths and the mortality rate can be as high as 60% if the patient goes into shock from infection. Survival depends upon thousands of independent pieces coming together in an organized way. A patient doesn’t come to the emergency department and say “I have sepsis”. He may arrive by ambulance or be brought in by a relative and simply feel weak, or confused or have a fever.
