hospital mortality


Summary: A vital statistic measuring or recording the rate of death from any cause in hospitalized populations.

Top Publications

  1. Magrini L, Travaglino F, Marino R, Ferri E, De Berardinis B, Cardelli P, et al. Procalcitonin variations after Emergency Department admission are highly predictive of hospital mortality in patients with acute infectious diseases. Eur Rev Med Pharmacol Sci. 2013;17 Suppl 1:133-42 pubmed
    ..ED) with signs of infections and to assess the prognostic value of repeated measurements in predicting hospital mortality. A prospective, observational study was conducted in our 400-bed General Teaching Hospital...
  2. Green J, Berger T, Garg N, Horeczko T, Suarez A, Radeos M, et al. Hyperlactatemia affects the association of hyperglycemia with mortality in nondiabetic adults with sepsis. Acad Emerg Med. 2012;19:1268-75 pubmed publisher
    ..Admission hyperglycemia has been reported as a mortality risk factor for septic nondiabetic patients; however, hyperglycemia's known association with hyperlactatemia was not addressed in these analyses...
  3. Parenica J, Spinar J, Vitovec J, Widimsky P, Linhart A, Fedorco M, et al. Long-term survival following acute heart failure: the Acute Heart Failure Database Main registry (AHEAD Main). Eur J Intern Med. 2013;24:151-60 pubmed publisher
    The in-hospital mortality of patients with acute heart failure (AHF) is reported to be 12.7% and mortality on day 30 after admission 17.2%...
  4. Grant S, Hickey G, Grayson A, Mitchell D, McCollum C. National risk prediction model for elective abdominal aortic aneurysm repair. Br J Surg. 2013;100:645-53 pubmed publisher
    ..The study outcome measure was in-hospital mortality. Model calibration and discrimination were assessed for all AAA repairs, and separately for open repair and ..
  5. Janz D, Bastarache J, Peterson J, Sills G, Wickersham N, May A, et al. Association between cell-free hemoglobin, acetaminophen, and mortality in patients with sepsis: an observational study. Crit Care Med. 2013;41:784-90 pubmed publisher
    ..Acetaminophen may exert a protective effect by reducing cell-free hemoglobin-induced oxidative injury. ..
  6. Arnold F, Wiemken T, Peyrani P, Ramirez J, Brock G. Mortality differences among hospitalized patients with community-acquired pneumonia in three world regions: results from the Community-Acquired Pneumonia Organization (CAPO) International Cohort Study. Respir Med. 2013;107:1101-11 pubmed publisher
    ..Treatment regimen (fluoroquinolone and macrolide use) and preventive measures (vaccinations) were variables that may be modified to help alleviate the differences. ..
  7. Heyland D, Muscedere J, Wischmeyer P, Cook D, Jones G, Albert M, et al. A randomized trial of glutamine and antioxidants in critically ill patients. N Engl J Med. 2013;368:1489-97 pubmed publisher
    ..Critically ill patients have considerable oxidative stress. Glutamine and antioxidant supplementation may offer therapeutic benefit, although current data are conflicting...
  8. De Meester K, Verspuy M, Monsieurs K, Van Bogaert P. SBAR improves nurse-physician communication and reduces unexpected death: a pre and post intervention study. Resuscitation. 2013;84:1192-6 pubmed publisher
    ..After introducing SBAR we found increased perception of effective communication and collaboration in nurses, an increase in unplanned ICU admissions and a decrease in unexpected deaths. ..
  9. Trinh V, Trinh Q, Tian Z, Hu J, Shariat S, Perrotte P, et al. In-hospital mortality and failure-to-rescue rates after radical cystectomy. BJU Int. 2013;112:E20-7 pubmed publisher
    ..Whereas both patient and hospital characteristics were associated with increased odds of FTR, the occurrence of septicaemia and cardiac complications were the most strongly associated with a higher risk of in-hospital mortality.

Scientific Experts

More Information


  1. Suberviola B, Castellanos Ortega A, Ruiz Ruiz A, Lopez Hoyos M, Santibanez M. Hospital mortality prognostication in sepsis using the new biomarkers suPAR and proADM in a single determination on ICU admission. Intensive Care Med. 2013;39:1945-52 pubmed publisher
    ..The best area under the curve (AUC) for the prediction of in-hospital mortality was for APACHE II (0.82) and SOFA (0.75) scores. The ROC curve for suPAR yielded an AUC of 0...
  2. Aubron C, Cheng A, Pilcher D, Leong T, Magrin G, Cooper D, et al. Infections acquired by adults who receive extracorporeal membrane oxygenation: risk factors and outcome. Infect Control Hosp Epidemiol. 2013;34:24-30 pubmed publisher
    ..The probability of infection increased with the duration of support and the severity of illness before initiation of ECMO. Infections affected length of stay but did not have an impact on mortality. ..
  3. Hickey G, Grant S, Caiado C, Kendall S, Dunning J, Poullis M, et al. Dynamic prediction modeling approaches for cardiac surgery. Circ Cardiovasc Qual Outcomes. 2013;6:649-58 pubmed publisher
    ..We compare different model fitting approaches for in-hospital mortality after cardiac surgery that adjust for cross-sectional case mix in a heterogeneous patient population...
  4. Siregar S, Pouw M, Moons K, Versteegh M, Bots M, van der Graaf Y, et al. The Dutch hospital standardised mortality ratio (HSMR) method and cardiac surgery: benchmarking in a national cohort using hospital administration data versus a clinical database. Heart. 2014;100:702-10 pubmed publisher
    ..The use of either administrative or clinical risk-adjustment models can affect the outlier status of hospitals. Risk-adjustment models including procedure-specific clinical risk factors are recommended. ..
  5. Mullen M, Kasner S, Messe S. Seizures do not increase in-hospital mortality after intracerebral hemorrhage in the nationwide inpatient sample. Neurocrit Care. 2013;19:19-24 pubmed publisher
    ..We hypothesized that seizures would not increase the risk of in-hospital mortality in a large administrative database...
  6. Mediratta N, Chalmers J, Pullan M, McShane J, Shaw M, Poullis M. In-hospital mortality and long-term survival after coronary artery bypass surgery in young patients. Eur J Cardiothorac Surg. 2013;43:1014-21 pubmed publisher
    ..We aimed to determine the factors that contribute to in-hospital mortality and long-term survival in young patients (aged less than 65) undergoing CABG...
  7. Swaminathan R, Wang T, Kaltenbach L, Kim L, Minutello R, Bergman G, et al. Nonsystem reasons for delay in door-to-balloon time and associated in-hospital mortality: a report from the National Cardiovascular Data Registry. J Am Coll Cardiol. 2013;61:1688-95 pubmed publisher was to characterize nonsystem reasons for delay in door-to-balloon time (D2BT) and the impact on in-hospital mortality. Studies have evaluated predictors of delay in D2BT, highlighting system-related issues and patient ..
  8. Walkey A, Wiener R, Lindenauer P. Utilization patterns and outcomes associated with central venous catheter in septic shock: a population-based study. Crit Care Med. 2013;41:1450-7 pubmed publisher
    ..of septic shock cases receiving an early (day of admission) central venous catheter and the odds of hospital mortality associated with receiving early central venous catheter from years 1998 to 2001 compared with 2002 to 2009...
  9. Seghieri C, Mimmi S, Lenzi J, Fantini M. 30-day in-hospital mortality after acute myocardial infarction in Tuscany (Italy): an observational study using hospital discharge data. BMC Med Res Methodol. 2012;12:170 pubmed publisher
    ..The aim of this study was to examine the determinants of inter-hospital variability on 30-day in-hospital mortality after AMI in Tuscany...
  10. Lim S, Koh S, Jeon K, Na S, Lim C, Choi W, et al. Validation of SAPS3 admission score and its customization for use in Korean intensive care unit patients: a prospective multicentre study. Respirology. 2013;18:989-95 pubmed publisher
    ..A total of 4617 patients were enrolled. ICU mortality was 14.3%, and hospital mortality was 20.6%...
  11. Pickkers P, de Keizer N, Dusseljee J, Weerheijm D, Van Der Hoeven J, Peek N. Body mass index is associated with hospital mortality in critically ill patients: an observational cohort study. Crit Care Med. 2013;41:1878-83 pubmed publisher
    ..Nevertheless, some studies suggest that being overweight may reduce hospital mortality of certain patient groups, referred to as obesity paradox...
  12. Urtecho J, Snapp M, Sperling M, Maltenfort M, Vibbert M, Athar M, et al. Hospital mortality in primary admissions of septic patients with status epilepticus in the United States*. Crit Care Med. 2013;41:1853-62 pubmed publisher
    To determine the prevalence of status epilepticus, associated factors, and relationship with in-hospital mortality in primary admissions of septic patients in the United States. Cross-sectional study...
  13. Kontos M, Wang Y, Chaudhry S, Vetrovec G, Curtis J, Messenger J. Lower hospital volume is associated with higher in-hospital mortality in patients undergoing primary percutaneous coronary intervention for ST-segment-elevation myocardial infarction: A report from the NCDR. Circ Cardiovasc Qual Outcomes. 2013;6:659-67 pubmed publisher
    ..In-hospital mortality and door-to-balloon time were examined for each group...
  14. Hsieh C, Su L, Wang Y, Fu C, Lo H, Lin C. Does alcohol intoxication protect patients from severe injury and reduce hospital mortality? The association of alcohol consumption with the severity of injury and survival in trauma patients. Am Surg. 2013;79:1289-94 pubmed
    ..Additional research is required to investigate the mechanism of this association further. ..
  15. Aiken L, Sloane D, Bruyneel L, Van den Heede K, Griffiths P, Busse R, et al. Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. Lancet. 2014;383:1824-30 pubmed publisher nine of the 12 RN4CAST countries with similar patient discharge data were associated with variation in hospital mortality after common surgical procedures...
  16. Arabi Y, Khedr M, Dara S, Dhar G, Bhat S, Tamim H, et al. Use of intermittent pneumatic compression and not graduated compression stockings is associated with lower incident VTE in critically ill patients: a multiple propensity scores adjusted analysis. Chest. 2013;144:152-159 pubmed publisher
    ..The objective of this study was to examine the association of mechanical thromboprophylaxis with IPC or GCS with the risk of VTE and hospital mortality among critically ill medical-surgical patients.
  17. Perez Padilla R, García Sancho C, Fernandez R, Franco Marina F, Lopez Gatell H, Bojorquez I. The impact of altitude on hospitalization and hospital mortality from pandemic 2009 influenza A (H1N1) virus pneumonia in Mexico. Salud Publica Mex. 2013;55:92-5 pubmed
    ..Adjusted rates for hospitalization and hospital mortality rates increased with altitude, probably due to hypoxemia.
  18. Nisula S, Kaukonen K, Vaara S, Korhonen A, Poukkanen M, Karlsson S, et al. Incidence, risk factors and 90-day mortality of patients with acute kidney injury in Finnish intensive care units: the FINNAKI study. Intensive Care Med. 2013;39:420-8 pubmed publisher
    ..b>Hospital mortality (95 % CI) for AKI patients was 25.6 % (23.0-28.2 %) and the 90-day mortality for AKI patients was 33.7 % (30...
  19. Girotra S, Nallamothu B, Spertus J, Li Y, Krumholz H, Chan P. Trends in survival after in-hospital cardiac arrest. N Engl J Med. 2012;367:1912-20 pubmed publisher
    ..Both survival and neurologic outcomes after in-hospital cardiac arrest have improved during the past decade at hospitals participating in a large national quality-improvement registry. (Funded by the American Heart Association.). ..
  20. Agarwal E, Ferguson M, Banks M, Batterham M, Bauer J, Capra S, et al. Malnutrition and poor food intake are associated with prolonged hospital stay, frequent readmissions, and greater in-hospital mortality: results from the Nutrition Care Day Survey 2010. Clin Nutr. 2013;32:737-45 pubmed publisher
    ..2) were collected 90-days post-Phase 1 and included length of hospital stay (LOS), readmissions and in-hospital mortality. Of 3122 participants (47% females, 65 ± 18 years) from 56 hospitals, 32% were malnourished and 23% ..
  21. Young D, Lamb S, Shah S, Mackenzie I, Tunnicliffe W, Lall R, et al. High-frequency oscillation for acute respiratory distress syndrome. N Engl J Med. 2013;368:806-13 pubmed publisher
    ..Funded by the National Institute for Health Research Health Technology Assessment Programme; OSCAR Current Controlled Trials number, ISRCTN10416500.). ..
  22. Lin J, Chung X, Yang C, Lau H. A meta-analysis of trials using the intention to treat principle for glutamine supplementation in critically ill patients with burn. Burns. 2013;39:565-70 pubmed publisher
    ..27, 95% CI 0.08-0.92, p=0.04) and hospital mortality (OR=0.13, 95% CI 0.03, 0.51, p=0...
  23. Seymour C, Cooke C, Heckbert S, Copass M, Yealy D, Spertus J, et al. Prehospital systolic blood pressure thresholds: a community-based outcomes study. Acad Emerg Med. 2013;20:597-604 pubmed publisher
    ..Prehospital sBP is a modest discriminator of clinical outcomes, yet no threshold avoids substantial misclassification of 30-day mortality among noninjured patients. ..
  24. Saver J, Fonarow G, Smith E, Reeves M, Grau Sepulveda M, Pan W, et al. Time to treatment with intravenous tissue plasminogen activator and outcome from acute ischemic stroke. JAMA. 2013;309:2480-8 pubmed publisher
    ..However, modest sample sizes have limited characterization of the extent to which onset to treatment (OTT) time influences outcome; and the generalizability of findings to clinical practice is uncertain...
  25. Lenihan C, Montez Rath M, Mora Mangano C, Chertow G, Winkelmayer W. Trends in acute kidney injury, associated use of dialysis, and mortality after cardiac surgery, 1999 to 2008. Ann Thorac Surg. 2013;95:20-8 pubmed publisher
    ..In sum, despite improvements in individual patient outcomes over the decade 1999 to 2008, the population contribution of AKI and AKI-D to inpatient mortality after surgery increased over the same period. ..
  26. Imani P, Odiit A, Hingorani S, Weiss N, Eddy A. Acute kidney injury and its association with in-hospital mortality among children with acute infections. Pediatr Nephrol. 2013;28:2199-206 pubmed publisher
    We investigated prevalence of acute kidney injury (AKI) at hospitalization and its association with in-hospital mortality among Ugandan children hospitalized with common acute infections, and predictors of mortality among AKI children...
  27. van Beek S, Blankensteijn J, Balm R. Validation of three models predicting in-hospital death in patients with an abdominal aortic aneurysm eligible for both endovascular and open repair. J Vasc Surg. 2013;58:1452-1457.e1 pubmed publisher
    ..Therefore, these models can be used to support deciding between endovascular and open repair. ..
  28. Kim S, Jeong M, Rhew S, Jeong W, Ahn Y, Cho J, et al. Impact of patients' arrival time on the care and in-hospital mortality in patients with non-ST-elevation myocardial infarction. Am J Cardiol. 2014;113:262-9 pubmed publisher compare the impact of patients' arrival time on the care of NSTEMI and whether this pattern might affect hospital mortality. This study analyzed 4,736 NSTEMI patients included in the Korea Acute Myocardial Infarction Registry from ..
  29. Arulkumaran N, Annear N, Singer M. Patients with end-stage renal disease admitted to the intensive care unit: systematic review. Br J Anaesth. 2013;110:13-20 pubmed publisher
    ..acute kidney injury (AKI) requiring renal replacement therapy (RRT) is associated with significantly higher hospital mortality compared with ESRD patients admitted to the ICU [odds ratio (OR) 3.9; 3.5-4.4; P<0.0001]...
  30. Kramer A, Higgins T, Zimmerman J. The association between ICU readmission rate and patient outcomes. Crit Care Med. 2013;41:24-33 pubmed publisher
    ..None. The median unit readmission rate was 5.9% (intraquartile range 5.1%-7.0%). Across all admissions, hospital mortality for patients with and without readmission was 21.3% vs. 3.6%, mean ICU stay 4.9 days vs. 3...
  31. Raghunathan K, Shaw A, Nathanson B, STURMER T, Brookhart A, Stefan M, et al. Association between the choice of IV crystalloid and in-hospital mortality among critically ill adults with sepsis*. Crit Care Med. 2014;42:1585-91 pubmed publisher
    ..We examined the association between choice of crystalloids and in-hospital mortality during the resuscitation of critically ill adults with sepsis...
  32. Spolverato G, Ejaz A, Hyder O, Kim Y, Pawlik T. Failure to rescue as a source of variation in hospital mortality after hepatic surgery. Br J Surg. 2014;101:836-46 pubmed publisher
    ..The reduction in mortality appears to be the result of both lower complication rates and a better ability in high-volume hospitals to rescue patients with major complications. ..
  33. Bastin A, Ostermann M, Slack A, Diller G, Finney S, Evans T. Acute kidney injury after cardiac surgery according to Risk/Injury/Failure/Loss/End-stage, Acute Kidney Injury Network, and Kidney Disease: Improving Global Outcomes classifications. J Crit Care. 2013;28:389-96 pubmed publisher
    ..The area under the receiver operating characteristic curve for hospital mortality was significantly higher using the AKIN compared with the RIFLE criteria (0.86 vs 0.78, P = .0009)...
  34. Herrett E, Shah A, Boggon R, Denaxas S, Smeeth L, van Staa T, et al. Completeness and diagnostic validity of recording acute myocardial infarction events in primary care, hospital care, disease registry, and national mortality records: cohort study. BMJ. 2013;346:f2350 pubmed publisher
    ..NCT01569139 ..
  35. Kerlin M, Small D, Cooney E, Fuchs B, Bellini L, Mikkelsen M, et al. A randomized trial of nighttime physician staffing in an intensive care unit. N Engl J Med. 2013;368:2201-9 pubmed publisher
    ..Secondary outcomes were patients' length of stay in the hospital, ICU and in-hospital mortality, discharge disposition, and rates of readmission to the ICU...
  36. Wu M, Tseng Y, Chang Y, Tsai F, Lin P. Using extracorporeal membrane oxygenation to rescue acute myocardial infarction with cardiopulmonary collapse: the impact of early coronary revascularization. Resuscitation. 2013;84:940-5 pubmed publisher
    ..3, 95% CI: 1.1-51.0) and profound anoxic encephalopathy (OR 24.6, 95% CI: 2.3-263.0) predicted in-hospital mortality. The major cardiovascular adverse effect (MACE)-free survival was 77% in the first year after discharge...
  37. Miller R, Dong L, Nelson N, Brown S, Kuttler K, Probst D, et al. Multicenter implementation of a severe sepsis and septic shock treatment bundle. Am J Respir Crit Care Med. 2013;188:77-82 pubmed publisher
    ..or septic shock admitted to study ICUs from the emergency department between January 2004 and December 2010, hospital mortality was 12.1%, declining from 21.2% in 2004 to 8.7% in 2010...
  38. Pouw M, Peelen L, Lingsma H, Pieter D, Steyerberg E, Kalkman C, et al. Hospital standardized mortality ratio: consequences of adjusting hospital mortality with indirect standardization. PLoS ONE. 2013;8:e59160 pubmed publisher
    ..Different methods can be used to standardize the hospital mortality ratio...
  39. Ferguson N, Cook D, Guyatt G, Mehta S, Hand L, Austin P, et al. High-frequency oscillation in early acute respiratory distress syndrome. N Engl J Med. 2013;368:795-805 pubmed publisher
    ..In-hospital mortality was 47% in the HFOV group, as compared with 35% in the control group (relative risk of death with HFOV, 1...
  40. Ploemacher J, Israëls A, van der Laan D, de Bruin A. [Standardised in-hospital mortality decreasing over time]. Ned Tijdschr Geneeskd. 2013;157:A5267 pubmed
    To study the changes in standardised in-hospital mortality in the period 2005 to 2010. Retrospective, descriptive study...
  41. Peck R, Green E, Mtabaji J, Majinge C, Smart L, Downs J, et al. Hypertension-related diseases as a common cause of hospital mortality in Tanzania: a 3-year prospective study. J Hypertens. 2013;31:1806-11 pubmed publisher
    ..diagnoses were recorded for all medical admissions together with age, sex, length of hospitalization and in-hospital mortality. Among 11045 consecutive admissions, NCDs accounted for nearly half of all deaths, admissions, and hospital ..
  42. Sassoon A, D Apuzzo M, Sems S, Cass J, Mabry T. Total hip arthroplasty for femoral neck fracture: comparing in-hospital mortality, complications, and disposition to an elective patient population. J Arthroplasty. 2013;28:1659-62 pubmed publisher
    ..The length of stay and the percentage of patients discharging to a rehab facility were significantly higher in the FNF group at each time interval. ..
  43. Escobar G, Gardner M, Greene J, Draper D, Kipnis P. Risk-adjusting hospital mortality using a comprehensive electronic record in an integrated health care delivery system. Med Care. 2013;51:446-53 pubmed publisher
    ..295. Results for inpatient and 30-day mortality were virtually identical. Risk-adjustment of hospital mortality using comprehensive electronic medical records is feasible and permits one to develop statistical models ..
  44. Ratanarat R, Skulratanasak P, Tangkawattanakul N, Hantaweepant C. Clinical accuracy of RIFLE and Acute Kidney Injury Network (AKIN) criteria for predicting hospital mortality in critically ill patients with multi-organ dysfunction syndrome. J Med Assoc Thai. 2013;96 Suppl 2:S224-31 pubmed
    ..according to the maximum RIFLE and AKIN classification reached during their hospital stay Demographic data, hospital mortality, hospital length of stay, need of renal replacement therapy was collected...
  45. Stevenson E, Rubenstein A, Radin G, Wiener R, Walkey A. Two decades of mortality trends among patients with severe sepsis: a comparative meta-analysis*. Crit Care Med. 2014;42:625-31 pubmed publisher
    ..53; 95% CI, 0.50-0.57) during years 2006-2009 (3.0% annual change). Trends in hospital mortality among patients with severe sepsis identified from administrative data (Angus definition, 4...
  46. Manda S, Gale C, Hall A, Gilthorpe M. Statistical profiling of hospital performance using acute coronary syndrome mortality. Cardiovasc J Afr. 2012;23:546-51 pubmed publisher
    ..Therefore there is a need to find robust systems of 'regulation' or 'performance monitoring' that are meaningful to health service practitioners and providers. ..
  47. Albright K, Savitz S, Raman R, Martin Schild S, Broderick J, Ernstrom K, et al. Comprehensive stroke centers and the 'weekend effect': the SPOTRIAS experience. Cerebrovasc Dis. 2012;34:424-9 pubmed publisher
    ..This further highlights the importance of organized stroke care. ..
  48. Mokhlesi B, Hovda M, Vekhter B, Arora V, Chung F, Meltzer D. Sleep-disordered breathing and postoperative outcomes after bariatric surgery: analysis of the nationwide inpatient sample. Obes Surg. 2013;23:1842-51 pubmed publisher
    ..sample, despite the increased association of SDB/OSA with postoperative cardiopulmonary complications, the diagnosis of SDB/OSA was negatively, rather than positively, associated with in-hospital mortality and resource use.
  49. Chhatriwalla A, Amin A, Kennedy K, House J, Cohen D, Rao S, et al. Association between bleeding events and in-hospital mortality after percutaneous coronary intervention. JAMA. 2013;309:1022-9 pubmed publisher
    ..The incidence of bleeding-related mortality after PCI has not been described in a nationally representative population. Furthermore, the relationships among bleeding risk, bleeding site, and mortality are unclear...
  50. Morr M, Lukasz A, Rübig E, Pavenstadt H, Kümpers P. Sepsis recognition in the emergency department - impact on quality of care and outcome?. BMC Emerg Med. 2017;17:11 pubmed publisher
    ..12%, p?=?0.55). Non-recognition of sepsis in ED patients with serious infections who formally meet organizational sepsis definitions seems to have no deleterious impact on initial therapy adequacy. ..
  51. Emrath E, Fortenberry J, Travers C, McCracken C, Hebbar K. Resuscitation With Balanced Fluids Is Associated With Improved Survival in Pediatric Severe Sepsis. Crit Care Med. 2017;45:1177-1183 pubmed publisher
  52. Velásquez Rodríguez J, Diez Delhoyo F, Valero Masa M, Vicent L, Devesa C, Sousa Casasnovas I, et al. Prognostic Impact of Age and Hemoglobin in Acute ST-Segment Elevation Myocardial Infarction Treated With Reperfusion Therapy. Am J Cardiol. 2017;119:1909-1916 pubmed publisher
    ..The association of hemoglobin with hospital mortality was seen in men and in women ≥65 years...
  53. Jalisi S, Rubin S, Wu K, Kirke D. Outcomes of head and neck cancer surgery in the geriatric population based on case volume at academic centers. Laryngoscope. 2017;127:2539-2544 pubmed publisher
    ..2b. Laryngoscope, 127:2539-2544, 2017. ..