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OBJECTIVE To determine the incidence, cost, and outcome of severe sepsis in the United States. DESIGN Observational cohort study. SETTING All nonfederal hospitals (n = 847) in seven U.S. states. PATIENTS All patients (n = 192,980) meeting criteria for severe sepsis based on the International Classification of Diseases, Ninth Revision, Clinical(More)
There is little information on long-term outcome after acute respiratory distress syndrome (ARDS). We measured quality-adjusted survival in the first year after ARDS in a prospective cohort (n = 200). All patients met traditional criteria for ARDS. Patients with sepsis and acute nonpulmonary organ dysfunction at presentation were excluded. The cohort was(More)
OBJECTIVE To determine whether insurance status (managed care vs traditional commercial and Medicare) influences resource consumption (as measured by length of stay [LOS]) in the intensive care unit (ICU). DESIGN Retrospective analysis of the 1992 Massachusetts state hospital discharge database, using prospectively developed and validated(More)
We wanted to determine the incidence, cost, outcome, and patterns of care for neonates requiring mechanical ventilation (MV) in the United States. Using 1994 state hospital discharge data from California and New York, we conducted an observational study of all neonatal hospitalizations (n = 16,405) with MV, comparing outcomes at centers of different(More)
OBJECTIVE To evaluate the relationship between the postoperative Acute Physiology and Chronic Health Evaluation (APACHE) II score and mortality at hospital discharge and at 1 yr in liver transplant recipients. POPULATION Adult orthotopic liver transplant (OLTX) recipients (n = 599) admitted to the intensive care unit postoperatively at a university(More)
OBJECTIVE Logistic regression (LR), commonly used for hospital mortality prediction, has limitations. Artificial neural networks (ANNs) have been proposed as an alternative. We compared the performance of these approaches by using stepwise reductions in sample size. DESIGN Prospective cohort study. SETTING Seven intensive care units (ICU) at one(More)
OBJECTIVES Death rates for community-acquired pneumonia based on relatively small-scale, published studies tend to exceed 15% to 20%. This study reexamined these estimates by using very large, population-based databases. METHODS Death rates from 1993 associated with community-acquired pneumonia were reexamined with hospital discharge data from all of(More)
OBJECTIVE To describe an approach for using claims data to compare the effectiveness of 2 similar drugs used for similar indications within a health maintenance organization. STUDY DESIGN A database study comparing the effectiveness of amlodipine and nifedipine CC in the initial treatment of hypertension. PATIENTS AND METHODS The claims records of(More)