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CMAJ. 2010 April 6; 182(6): 531.
PMCID: PMC2845674

Highlights

Predicting early death or readmission after discharge from hospital

Van Walraven and colleagues present a new index for use by clinicians, researchers and administrators to quantify the risk of patient death or unplanned readmission within 30 days after discharge from hospital. The index is based on length of stay in hospital, acuity of the admission, comorbidities and use of emergency care. Citing its limitations, the authors note that clinicians may find it difficult to commit to memory the point system used and its expected risk. See Research, page 551

Using a tool to identify preventable readmissions is one of four possible strategies that countries can use to reduce such readmissions, says Goldfield. See Commentary, page 538

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What is your height?

Women over 60 years of age incorrectly report their height, with a mean difference of −2.4 cm from their current measured height. This is the finding of Briot and colleagues in their observational study involving 8610 postmenopausal women. Previous vertebral fracture and thoracic kyphosis were strong determinants of loss of height in these women. See Research, page 558

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When terminally ill patients seek emergency care near the end of life

Many visits made to emergency departments by patients with cancer in the final days and weeks of life may be avoidable. Barbera and colleagues come to this conclusion in their retrospective cohort study based on administrative sources of data. Pain and failure to cope emerged as common underlying reasons for using emergency services. See Research, page 563

Parenthood and the risk of suicide

Having more children was associated with decreasing rates of death from suicide in a cohort of women from Taiwan studied by Yang. The researcher linked data from a birth registry with a mortality database to study over one million women. The adjusted hazard ratio for suicide was 0.61 (95% confidence interval [CI] 0.54–0.68) among women with two live births and 0.40 (95% CI 0.35–0.45) among those with three or more live births, compared with women who had one live birth. See Research, page 569

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Keeping our children safe

Deaths of children from injury are preventable with better planning of the environment where they live, work and go to school. Health advocates and policy-makers should consider modifying the built environment when promoting the safety of children, says Howard. See Review, page 573

Cushing syndrome

A 47-year-old woman with a round face, prominent preauricular fat pads and an elevated urinary cortisol level provides an opportunity to learn how to differentiate between endogenous and exogenous Cushing syndrome. See Practice, page 584

Pituitary tumour

A young man complained of decreased libido and white discharge from his right breast. The serum prolactin level was elevated and magnetic resonance imaging showed a prolactinoma. See Clinical images, page 591

Federal budget light on initiatives for health and research

The federal budget offers little in the way of new health or research initiatives, although Finance Minister Jim Flaherty did take tentative steps toward resolving the medical isotope supply problem and provided modest relief to help offset scheduled cuts in the granting council budgets. See News, page 542


Articles from CMAJ : Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association