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[Observed vs expected mortality in the emergency service of a general hospital. Evaluation by the APACHE II and multiple organ failure classification systems].

UNLABELLED: Problem that originated the investigation: It was not known if the observed mortality in the Emergency room of the Tijuana General Hospital was lower, equal or higher, than the expected mortality. OBJECTIVES: 1) Evaluate in a prospective fashion the mortality rate in that hospital service, and then compare that rate with an expected mortality rate proposed in the literature (Role). 2) Determine the prognostic value in our hospital of the Multiple Organ Failure classification system (MOF). The Multiple Organ Failure classification system showed in our study an excellent predicting capacity for mortality.

APACHE↗
PubMed2002

The increasing incidence of coronary artery disease and cardiovascular risk factors among a Southwest Native American tribe: the White Mountain Apache Heart Study.

BACKGROUND: Rates of cardiovascular disease and its risk factors seem to be increasing in American Indian populations, yet these changes have received little documentation. OBJECTIVES: To evaluate incidence rates of coronary artery disease, acute myocardial infarction, and cardiac events during a 10-year period (1987-1996); to assess cardiac risk factors for an American Indian tribe in Arizona. METHODS: A retrospective medical chart review was performed for tribal members from January 1, 1987-December 31, 1996. Patient records with even minor indications of coronary disease were reviewed independently by 2 cardiologists of the Native American Cardiology Program. Multiple databases were reviewed in an effort to find all diagnoses, and incidence rates were calculated and analyzed for increasing trends. Cardiac risk factors were assessed in a population convenience sample. RESULTS: From 1987 through 1996, the number of incident cases increased from 3 to 18 for coronary artery disease, 1 to 10 for acute myocardial infarction, and 3 to 26 for cardiac events. Statistically significant increasing trends were calculated for each. Of our youthful convenience sample, 49% had 2 or more cardiac risk factors. CONCLUSIONS: This study confirms increasing rates of coronary artery disease and its comorbidities in this American Indian population and demonstrates high prevalence of cardiovascular risk factors among tribal members without extant coronary disease. This suggests that coronary disease will likely continue to increase as this population ages. To prevent such increases, culturally appropriate, aggressive preventive interventions are needed.

Adult↗