BMJ 2007; 334 doi: https://doi.org/10.1136/bmj.39121.565729.471 (Published 15 February 2007) Cite this as: BMJ 2007;334:374

The standardised mortality ratio is a commonly used measure of performance in intensive care. But, as a simulation study in Chest (2007;131:68-75 doi: 10.1378/chest.06-0741) shows, even a small increase in the number of transfers of critically ill patients to other acute care hospitals can significantly bias the ratio. This may influence conclusions about the quality of the intensive care unit from which the patient was discharged. The researchers say this finding limits the use of the standardised mortality ratio as a quality measure.

Different surgical approaches to resurfacing the hip influence the perfusion of the femoral head in different ways. In 20 operations, surgeons measured the concentration of the antibiotic cefuroxime in bone samples taken from the femoral head as a proxy for perfusion, and they concluded that the transgluteal approach offers significantly greater perfusion than the posterolateral approach (J Bone Joint Surgery(Br) 2007;89B:21-5 doi: 10.1302/0301-620X.89B1.18330).

Nearly half (44%) of children with confirmed appendicitis present with six or more atypical features, making this a difficult diagnosis. A white cell count …

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