Mitral regurgitation late after manouguian's anulus enlargement and aortic valve replacement

AbstractJ Thorac Cardiovasc Surg 1998;115:727-

Transannular patch repair of double-outlet right ventricle, {s,d,l}, and single right coronary artery

AbstractJ Thorac Cardiovasc Surg 1999;117:622-

Assessment of activities and the participation domain based on the ICF for the elderly requiring care

ICFの「活動と参加」の評価を通して,要介護高齢者における生活機能低下の全体像を把握することを目的に調査を実施した.要介護高齢者672名を対象に,ICFの「活動と参加」の第2レベル73項目について,「実行状況」と「能力」の両面から評価点を評価し,Item　Indexとしてそれぞれの困難度を求めた.「活動と参加」における領域ごとの比較では第5領域「セルフケア」のItem Indexが最も低くなり,「実行状況」で37.7,「能力」で34.4となった.逆に高くなったのは第6領域「家庭生活」であり,それぞれ89.6,77.7となった.本研究の結果は要介護高齢者の生活機能低下の現状と評価手段としてのICF活用の可能性を示すものである.The purpose of this study was to understand the degree of functioning and disability level in elderly requiring care through the evaluation of each domain of "activity and participation" in ICF. The study investigated 672 elderly requiring care. In the investigation, regarding the 2nd level of 73 "activity and participation" domains in the ICF, the elderly were evaluated from "performance" and "capacity", and then converted to the Item Index. Subsequently, each item was evaluated, and the degree of difficulty for both performance and capacity was determined. In the comparison of both performance and capacity, the Item Index of Chapter 5 "SELF-CARE" was the lowest, while "performance" was 37. 7, and "capacity" was 34. 4. Conversely, the Item Index of Chapter 6 "DOMESTIC LIFE" became higher: it was 89. 6 and 77. 7 respectively. The results indicate the degree of both dysfunction and disability of the elderly requiring care, and also demonstrate the possibility of the ICF as an assessment tool

Performance of in-hospital mortality prediction models for acute hospitalization: Hospital Standardized Mortality Ratio in Japan

<p>Abstract</p> <p>Objective</p> <p>In-hospital mortality is an important performance measure for quality improvement, although it requires proper risk adjustment. We set out to develop in-hospital mortality prediction models for acute hospitalization using a nation-wide electronic administrative record system in Japan.</p> <p>Methods</p> <p>Administrative records of 224,207 patients (patients discharged from 82 hospitals in Japan between July 1, 2002 and October 31, 2002) were randomly split into preliminary (179,156 records) and test (45,051 records) groups. Study variables included Major Diagnostic Category, age, gender, ambulance use, admission status, length of hospital stay, comorbidity, and in-hospital mortality. ICD-10 codes were converted to calculate comorbidity scores based on Quan's methodology. Multivariate logistic regression analysis was then performed using in-hospital mortality as a dependent variable. C-indexes were calculated across risk groups in order to evaluate model performances.</p> <p>Results</p> <p>In-hospital mortality rates were 2.68% and 2.76% for the preliminary and test datasets, respectively. C-index values were 0.869 for the model that excluded length of stay and 0.841 for the model that included length of stay.</p> <p>Conclusion</p> <p>Risk models developed in this study included a set of variables easily accessible from administrative data, and still successfully exhibited a high degree of prediction accuracy. These models can be used to estimate in-hospital mortality rates of various diagnoses and procedures.</p