Armed Forces General Hospital Research Articles

Mortality rates under the care of junior and senior surgery residents in a surgical intensive care unit/neurologic intensive care unit: A 5-year retrospective cohort study at Taoyuan Armed Forces General Hospital

Background The quality and outcome of health care administered in intensive care units (ICUs) of teaching hospitals are dependent on a myriad of factors; however, few studies have assessed mortality rates and length of stay in surgical intensive care and neurologic intensive care units (SICU/NICU) in relation to the experience of junior and senior surgery residents. Objective The aim of this study was to determine whether there were differences in the outcomes of ICU patients cared for by junior surgery residents or senior surgery residents by assessing mortality rates and length of stay in the SICU/NICU. Design This was a retrospective cohort analysis. Mortality rates, length of SICU/NICU stay, and baseline characteristics were assessed in 2 patient groups: group 1, patients managed by junior surgical residents; group 2, patients managed by senior surgical residents. Categorical variables were compared by χ 2/Fisher exact test, and continuous data (age and ICU stay) were compared using the Mann-Whitney U test. Acute Physiology and Chronic Health Evaluation II score was used for ICU prognostic models. Setting The Taoyuan Armed Forces General Hospital (Taoyuan, Taiwan, ROC) consists of an 8-bed SICU and an 8-bed NICU. Patients Data were collected from 2274 patients from January 1, 2002, to December 31, 2006, from the intensive care units (SICU/NICU) of the department of surgery. Interventions None. Results Significant differences between the 2 groups were found in total patient mortality and the duration of intensive care unit stay. Of 1806 patients in group 1, 446 (24.7%) died, whereas 83 (17.7%) of 468 in group 2 died ( P = .002). The major difference of mortality rate was in the division of neurology surgery; 291 (26.6%) of 1092 patients in group 1 died, whereas 55 (19.2%) of 287 in group 2 died ( P = .009), with most deaths due to spontaneous intracranial hemorrhage ( P = .012) and central nervous system tumors ( P = .048). Median length of SICU/NICU stay for group 1 was 3.0 days vs 3.5 days for group 2 ( P = .003). Conclusions The quality of care of critically ill patients is improved when more experienced residents are providing care. We suggest that residents rotated into the special units such as SICU/NICU for care of critically ill patients should be at least at third year of training.

Mutation analysis of adenosine A2a receptor gene and interaction study with dopamine D2 receptor gene in schizophrenia

Psychiatry Division, Hualien Armed Forces General Hospital, Institute of Human Genetics, Department of Psychiatry, Tzu-Chi General Hospital and Tzu-Chi University, Hualien City and Division of Mental Health and Substance Abuse Research, National Health Research Institutes, Zhunan Town, Miaoli County, Taiwan Correspondence to Dr Chia-Hsiang Chen, MD, PhD, Division of Mental Health and Substance Abuse Research, National Health Research Institutes, Zhunan Town, Miaoli County 350, Taiwan Tel: + 886 37 246166 ext. 36713; fax: + 886 37 586453; e-mail: cchen@nhri.org.tw

Benigne Prostatahyperplasie

© 2010 Elsevier. All rights reserved. As men age, the prostate gland can enlarge to benign hyperplasia. Enlargement of the prostate can constrict the urethra, which can reduce urinary flow rates and cause urinary hesitancy, urgency, increased frequency, dysuria, and urinary tract infection. In addition to the mechanical component caused by the physically Received: Aug 26, 2009 Accepted: Nov 12, 2009 Address correspondence and reprint requests to: Professor Guang-Huan Sun, Department of Surgery, Taoyuan Armed Forces General Hospital, 168 Jong-Shing Road, Taoyuan County, 325 Taiwan. E-mail: ghsun@mail.ndmctsgh.edu.tw EFFICACY AND SAFETY OF THE DOXAZOSIN GASTROINTESTINAL THERAPEUTIC SYSTEM FOR THE TREATMENT OF BENIGN PROSTATE HYPERPLASIA