Abstract
Objectives: To assess predictive value of patient characteristics and severity of aneurysmal subarachnoid haemorrhage (SAH) patients for clinical outcomes, and thereby estimate risk-adjusted clinical outcomes and compare the outcomes across hospitals. Methods: We selected 256 aneurysmal SAH patients from eight teaching hospitals in Japan. The clinical outcomes of patients at the time of discharge were assessed by the Glasgow Outcome Scale (GOS). A multiple logistic regression analysis was performed to identify predictors for the GOS status at the time of discharge. The risk-adjusted proportion of patients with a favourable GOS outcome was then estimated for each facility and compared across hospitals. Results: The logistic regression analysis revealed that younger age (P < 0.001), patients with good World Federations of Neurological Surgeons grade at admission (P < 0.001) and absence of chronic renal failure or ischaemic heart disease as a comorbid condition (P < 0.001) were identified as significant predictors for favourable GOS outcome at the time of discharge among aneurysmal SAH patients (C statistic = 0.88). We found that one hospital had significantly better outcomes than the others. Conclusion: After comparison of risk-adjusted values across hospitals, the clinical management methods of the hospital that showed the best performance were examined and shared among providers.
| Original language | English |
|---|---|
| Pages (from-to) | 416-421 |
| Number of pages | 6 |
| Journal | Journal of Evaluation in Clinical Practice |
| Volume | 14 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Jun 1 2008 |
| Externally published | Yes |
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All Science Journal Classification (ASJC) codes
- Health Policy
- Public Health, Environmental and Occupational Health
Cite this
Comparisons of risk-adjusted clinical outcomes for patients with aneurysmal subarachnoid haemorrhage across eight teaching hospitals in Japan. / Ishizaki, Tatsuro; Imanaka, Yuichi; Sekimoto, Miho; Fukuda, Haruhisa; Mihara, Hanako; Itamoto, Kouji; Koizumi, Takayuki; Eguchi, Tsuneyoshi; Higashi, Sotaro; Nakamura, Tarou; Hayashi, Junichi; Yamagata, Sen; Natori, Yoshihiro.
In: Journal of Evaluation in Clinical Practice, Vol. 14, No. 3, 01.06.2008, p. 416-421.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Comparisons of risk-adjusted clinical outcomes for patients with aneurysmal subarachnoid haemorrhage across eight teaching hospitals in Japan
AU - Ishizaki, Tatsuro
AU - Imanaka, Yuichi
AU - Sekimoto, Miho
AU - Fukuda, Haruhisa
AU - Mihara, Hanako
AU - Itamoto, Kouji
AU - Koizumi, Takayuki
AU - Eguchi, Tsuneyoshi
AU - Higashi, Sotaro
AU - Nakamura, Tarou
AU - Hayashi, Junichi
AU - Yamagata, Sen
AU - Natori, Yoshihiro
PY - 2008/6/1
Y1 - 2008/6/1
N2 - Objectives: To assess predictive value of patient characteristics and severity of aneurysmal subarachnoid haemorrhage (SAH) patients for clinical outcomes, and thereby estimate risk-adjusted clinical outcomes and compare the outcomes across hospitals. Methods: We selected 256 aneurysmal SAH patients from eight teaching hospitals in Japan. The clinical outcomes of patients at the time of discharge were assessed by the Glasgow Outcome Scale (GOS). A multiple logistic regression analysis was performed to identify predictors for the GOS status at the time of discharge. The risk-adjusted proportion of patients with a favourable GOS outcome was then estimated for each facility and compared across hospitals. Results: The logistic regression analysis revealed that younger age (P < 0.001), patients with good World Federations of Neurological Surgeons grade at admission (P < 0.001) and absence of chronic renal failure or ischaemic heart disease as a comorbid condition (P < 0.001) were identified as significant predictors for favourable GOS outcome at the time of discharge among aneurysmal SAH patients (C statistic = 0.88). We found that one hospital had significantly better outcomes than the others. Conclusion: After comparison of risk-adjusted values across hospitals, the clinical management methods of the hospital that showed the best performance were examined and shared among providers.
AB - Objectives: To assess predictive value of patient characteristics and severity of aneurysmal subarachnoid haemorrhage (SAH) patients for clinical outcomes, and thereby estimate risk-adjusted clinical outcomes and compare the outcomes across hospitals. Methods: We selected 256 aneurysmal SAH patients from eight teaching hospitals in Japan. The clinical outcomes of patients at the time of discharge were assessed by the Glasgow Outcome Scale (GOS). A multiple logistic regression analysis was performed to identify predictors for the GOS status at the time of discharge. The risk-adjusted proportion of patients with a favourable GOS outcome was then estimated for each facility and compared across hospitals. Results: The logistic regression analysis revealed that younger age (P < 0.001), patients with good World Federations of Neurological Surgeons grade at admission (P < 0.001) and absence of chronic renal failure or ischaemic heart disease as a comorbid condition (P < 0.001) were identified as significant predictors for favourable GOS outcome at the time of discharge among aneurysmal SAH patients (C statistic = 0.88). We found that one hospital had significantly better outcomes than the others. Conclusion: After comparison of risk-adjusted values across hospitals, the clinical management methods of the hospital that showed the best performance were examined and shared among providers.
UR - http://www.scopus.com/inward/record.url?scp=43149083893&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=43149083893&partnerID=8YFLogxK
U2 - 10.1111/j.1365-2753.2007.00882.x
DO - 10.1111/j.1365-2753.2007.00882.x
M3 - Article
C2 - 18373576
AN - SCOPUS:43149083893
VL - 14
SP - 416
EP - 421
JO - Journal of Evaluation in Clinical Practice
JF - Journal of Evaluation in Clinical Practice
SN - 1356-1294
IS - 3
ER -