HealthGrades Evaluates Hospital Emergency Medicine for the First time

From FierceHealthcare, via Beth Cesta:

The quality of emergency medical care at the nation’s hospitals varies widely – both individually and by state – according to a new HealthGrades study released today that, for the first time, examines mortality rates for patients entering hospitals through emergency departments.

The first annual HealthGrades Emergency Medicine in American Hospitals Study examined more than 5 million Medicare records of patients admitted through the emergency department of 4,907 hospitals from 2006 to 2008 and identified hospitals that performed in the top 5% in the nation in emergency medicine.

Comparing the group of hospitals in the top 5% with all others, the study found that the group had a 39% lower risk-adjusted mortality rate. These top-performing hospitals improved their outcomes over the years 2006 through 2008 at a faster rate than all other hospitals, 16% compared with 10%.

Comparing tPA use for stroke in patients in their 80’s and 90’s

From Stroke:

Outcomes of Thrombolysis for Acute Ischemic Stroke in Octogenarians Versus Nonagenarians

Background and Purpose—Little is reported on the outcomes of nonagenarians who are treated with intravenous tissue plasminogen activator for acute ischemic stroke. It is uncertain whether nonagenarians have higher mortality and worse functional outcomes than octogenarians.

Conclusions—There is no significant difference in 90-day mortality, 30-day functional outcome, or rate of symptomatic intracerebral hemorrhage between nonagenarians and octogenarians treated with intravenous tissue plasminogen activator when comparing populations of similar baseline risk.