Sherman M A
JAMA. 1979 May 4;241(18):1899-1901.
Implementation of mobile intensive care units in four suburban communities permitted a retrospective evaluation of their impact on patient outcome. Data on 1,796 cases of myocardial infarction were obtained from medical reords and death certificates of patients arriving at four hospitals during a 65-month period. There were statistically significant reductions in mortality rates in two communities (41.1% to 23.9% and 37.6% to 27.0%) after the service began. A reduction in one community (34.5% to 22.0%) was not statistically significant, and the fourth community showed an increase in the mortality rate (31.1% to 44.0%). Analysis of plausible rival hypotheses permitted most of these to be ruled out as causes for the observed reduction in mortality.
在四个郊区社区实施移动重症监护病房,使得对其对患者预后的影响进行回顾性评估成为可能。在65个月的时间里,从四家医院接收的患者的病历和死亡证明中获取了1796例心肌梗死病例的数据。服务开始后,两个社区的死亡率有统计学意义的下降(分别从41.1%降至23.9%和从37.6%降至27.0%)。一个社区的死亡率下降(从34.5%降至22.0%)无统计学意义,而第四个社区的死亡率有所上升(从31.1%升至44.0%)。对看似合理的对立假设进行分析后,排除了其中大部分作为观察到的死亡率下降原因的可能性。