BMJ  2005;330 (25 June), doi:10.1136/bmj.330.7506.0-g

Editor's choice

Performance matters

The first 150 words of the full text of this article appear below.

It must be one of the worst nightmares of any clinician or parent—the failure to recognise or adequately treat a child with meningococcal infection. Death rates from meningococcal sepsis have not changed much over the past 20 to 30 years, despite growing appreciation of the benefits of aggressive management in intensive care. Perhaps this is because most children with meningococcal sepsis present to their local hospital and many die before they can be transferred to specialist intensive care units.

This is a disease where the quality of care really does mean the difference between life and death, as Nelly Ninis and colleagues show in their careful case control study (p 1475). The authors looked at the care given in the first 24 hours of admission to hospital, comparing children who died and children who survived, correcting for how sick the children were at presentation. Three factors were independently . . . [Full text of this article]

Fiona Godlee, editor

(fgodlee@bmj.com)


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