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Background: Similarity between the ICU patient data acquired by the APACHE system and the patient outcomes data acquired by the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) suggests that variables in NSQIP data could be effective mortality predictors. We theorized that identifying ACS-NSQIP preoperative data points predictive of patient outcomes would assist in identifying potential complications earlier., Study Design: Between 2006 and 2008 at the University of Maryland Medical Center, we identified 340 surgical ICU patients included in both databases as our study cohort. Median APACHE score calculation permitted division of study subjects into quartiles from which to examine length of stay, mortality variables, and ACS-NSQIP-recorded postoperative occurrences and preoperative risk factors. Outcomes were compared using each database's percentage of patients who had died., Results: Mortality was positively correlated with APACHE score increases. Initially, the average ICU length of stay increased, then declined. Most common postoperative occurrences were ventilator dependence >48 hours, pneumonia, unplanned intubation, sepsis, and septic shock. It was also noted that preoperative variables, such as American Society of Anesthesiologists classification and serum albumin levels, had an association with a poorer prognosis., Conclusions: APACHE score predictions are consistent with ACS-NSQIP-recorded postoperative outcomes. Higher APACHE scores correlated with increased incidence of postoperative outcomes and were associated with earlier mortality in the most extremely ill. Poorer states of health before surgery also correlated with poor outcomes postoperatively., (Copyright © 2011 American College of Surgeons. Published by Elsevier Inc. All rights reserved.)

Although research has emerged documenting the psychosocial impact of family care for cancer patients, few efforts capture the multi-dimensional nature of cancer caregiving stress, particularly among socioeconomically diverse samples. Utilizing data collected from cancer caregivers at a non-urban, Southern US site and an inner-city, Northeastern US site (N=233), the present study identified predictors of multiple dimensions of caregivers' subjective stress (i.e. emotional appraisals of care demands). Various indicators representing the sociodemographic context of care, cancer care demands, and psychosocial resources were found to exacerbate or buffer caregivers from feelings of exhaustion, role entrapment, and loss of intimacy with the cancer patient. The multivariate regression model also emphasized the diffuse yet potent role care recipient mood problems and caregiver mastery/optimism have on multiple dimensions of subjective stress. The findings offer a number of recommendations for future research and practice focused on informal cancer care.