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Biomedical subjects

H E Zimmerman

Publications and source records attributed to H E Zimmerman.

10 recordsLinked to original sources
PubMed1998

Do autopsies of critically ill patients reveal important findings that were clinically undetected?

OBJECTIVE: To determine if autopsies performed on patients who die in the medical intensive care unit (ICU) provide clinically important new information. DESIGN: Retrospective review. SETTING: A 16-bed medical-coronary ICU. PATIENTS: Patients who underwent autopsy during a 1-yr period. INTERVENTIONS: Pre mortem diagnoses were determined from the medical record. Autopsy results were obtained from the final pathology report. A panel of three physicians with certification of added qualifications in critical care medicine reviewed the findings. MEASUREMENTS AND MAIN RESULTS: These questions were asked: a) Is the primary clinical diagnosis confirmed? b) Are the clinical and pathologic causes of death the same? c) Are new active diagnoses revealed? and d) If the new findings had been known before death, would the clinical management have differed? Forty-one autopsies (31% of deaths) were done that showed: a) the same primary clinical diagnosis and post mortem diagnosis in 34 (83%) patients; b) the same clinical and pathologic cause of death in 27 (66%) patients; c) new active diagnoses in 37 (90%) patients; and d) findings that would have changed medical ICU therapy had the findings been known in 11 (27%) patients. CONCLUSIONS: Although the primary clinical diagnosis was accurate in most cases before death, the cause of death was frequently unknown. Almost all autopsies demonstrated new diagnoses, and knowledge of these new findings would have changed medical ICU therapy in many cases. In the critical care setting, autopsies continue to provide information that could be important for education and quality patient care.

Adolescent↗
PubMed1990

Framework for the Rhode Island response to the injury problem.

Injuries are the fourth leading cause of death in Rhode Island as well as the US and are responsible for the greatest amount of premature death. Recent years have brought more national attention to the role of public health in injury prevention. The Rhode Island Department of Health has been involved in a variety of injury control research, programs and legislation. In 1989, the Injury Prevention Program was funded through a grant from the Centers for Disease Control to coordinate and implement injury control programs in the Department. Injury prevention priorities are set on the basis of mortality and morbidity data. An analysis of Rhode Island death certificate data from 1979 to 1988 reveals that motor vehicle crashes, suicides, falls, and homicides are the leading causes of injury deaths. Age patterns vary for each cause, but males predominate in all categories of injury deaths. Activities to reduce injuries are underway or planned. Physicians will play key roles in this effort.

Adolescent↗