(Bernard SA. Ann. Surg. 2010; 252: <a href="http://www.selleckchem.com/products/DAPT-GSI-IX.html">DAPT
purchase</a> 959�C65) There are many studies published that demonstrate improved outcomes at high volume centres for surgical patients �C both trauma and elective surgery. This cross-sectional analysis looks at the mortality of ED patients admitted with sepsis �C specifically whether higher volume centres have the same mortality as lower volume centres. The database used was the 2007 Nationwide Inpatient Sample �C 8?043?415 discharges of adult patients from 1044 hospitals in 40 US states. After excluding transfers both in and out, there were 87?166 sepsis patient cases from 551 hospitals. Inhospital mortality was 18%, and the ��early�� mortality (<48?h) was 7%. The median caseload for each hospital was 249, with a range of 25�C1251. After excluding hospitals with <25 cases/year, there remained a wide variation of mortality in a normal distribution pattern. Inpatient mortality was significantly lower for the highest ED sepsis volume quartile. Multivariate logistic <a href="http://www.selleck.cn/products/dabrafenib-gsk2118436.html">Dabrafenib</a>
regression showed that patients admitted to the highest volume quartile had lower early mortality (odds ratio 0.69) and lower hospital mortality (odds ratio 0.73) compared with patients admitted to lowest volume quartile EDs. Teaching hospitals had higher mortality than non-teaching hospitals, and hospitals with larger numbers of beds had a higher mortality than small and medium sized hospitals. Clearly, there are many unmeasured factors in this cross sectional analysis that can affect sepsis mortality. However, the results reported here should encourage both measurement and comparison of sepsis mortality across hospitals, with analysis of high performing centres. Sepsis is common enough that all centres should accept sepsis patients, rather than see the development of specialized centres similar to the trauma model. (Powell ES. Crit. Care Med. 2010; 38: 2161�C8) In a similar fashion to the study above, the authors of this retrospective study sought to examine whether the outcome of out-of-hospital cardiac arrest (OOHCA) is different <a href="http://www.selleckchem.com/products/Adriamycin.html">Doxorubicin
mouse</a> in EDs that treat many or few such patients. The database used was a nationwide observational database of OOHCA patients in Korea. Eligible patients were patients with non-traumatic OOHCA with CPR attempted by paramedics. In general, only basic life support is supplied in Korea and each ambulance has an automatic external defibrillator. Over a 2?year period, 20?457 patients were identified, with 90% dying in the ED. A further 7% died in hospital, leaving a survival to discharge rate of 3.4%. The median caseload was 19, with a range of 0�C247. Only 10% were transported to Level 1 EDs, with a survival rate of 8%. Survival rates were lower for Level 2 EDs, and only 1% for Level 3 EDs.