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Thoracic Surgery Clinics

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https://www.readbyqxmd.com/read/28647079/quality-in-thoracic-surgery
#1
EDITORIAL
Felix G Fernandez
No abstract text is available yet for this article.
August 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28647078/hospital-readmission-following-thoracic-surgery
#2
REVIEW
Richard K Freeman
Hospital readmission costs the health care system in excess of 1 billion dollars a year. The Hospital Readmission Reduction Program was instituted as part of the Affordable Care Act in 2012 and penalizes hospitals with high rates of readmission. Strategies exist to minimize hospital readmissions and should be implemented by thoracic surgeons.
August 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28647077/international-general-thoracic-surgery-database-collaboration
#3
REVIEW
Christopher W Seder, Pierre-Emmanuel Falcoz, Michele Salati
One of the recent goals of the Society of Thoracic Surgeons General Thoracic Surgery Database (STS GTSD) Task Force has been an increased focus on international database collaboration. To date, such collaboration has primarily been with the European Society of Thoracic Surgeons (ESTS) Registry Task Force. This article provides an overview of the STS GTSD and ESTS registry, recent collaborative projects, obstacles encountered, and future directions for the databases.
August 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28647076/european-society-of-thoracic-surgeons-risk-scores
#4
REVIEW
Alessandro Brunelli
Risk-adjusted outcome analysis is pivotal for monitoring and improving quality of care. The European Society of Thoracic Surgeons established an online database more than 15 years ago. Several risk models and a composite score have been generated from the data included in the database. This report reviews the methods and applications of these risk scores.
August 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28647075/database-audit-in-thoracic-surgery
#5
REVIEW
Mitchell J Magee
Administrative data are less accurate and relevant than specialty-specific, procedure-specific, risk-adjusted data collected in voluntary registries such as the Society of Thoracic Surgeons-General Thoracic Surgery Database (GTSD). Voluntary clinical databases must be proven accurate and complete before they are accepted as credible information sources. With substantial growth of the GTSD, an annual audit was initiated in 2010 to assess the completeness, accuracy, and quality of the data collected. The audit process is essential in validating data quality and adding credibility and value to volunteer clinical registries...
August 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28647074/patient-reported-outcomes-in-thoracic-surgery
#6
REVIEW
Onkar V Khullar, Felix G Fernandez
The existing thoracic surgical literature contains several retrospective and observational studies that include patient-reported outcomes. To deliver true patient-centered care, it will be necessary to universally gather patient-reported outcomes prospectively, including them in routine patient care, clinical registries, and clinical trials.
August 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28647073/quality-and-cost-in-thoracic-surgery
#7
REVIEW
Rachel L Medbery, Seth D Force
The value of health care is defined as health outcomes (quality) achieved per dollars spent (cost). The current national health care landscape is focused on minimizing spending while optimizing patient outcomes. With the introduction of minimally invasive thoracic surgery, there has been concern about added cost relative to improved outcomes. Moreover, differences in postoperative hospital care further drive patient outcomes and health care costs. This article presents a comprehensive literature review on quality and cost in thoracic surgery and aims to investigate current challenges with regard to achieving the greatest value for our patients...
August 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28647072/failure-to-rescue-in-thoracic-surgery
#8
REVIEW
Farhood Farjah
Variability in outcomes not attributable to case mix or chance is an indicator of low-quality care. Failure-to-rescue is an outcome measure defined as death during a hospitalization among patients who experience a complication. Researchers have used this measure to better understand the determinants of an untimely death-preventing complications, rescue, or both. Studies repeatedly find that complication rates vary little, if at all, across hospitals ranked by risk-adjusted mortality rates, suggesting that hospitals are equally capable (or incapable) of preventing complications...
August 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28647071/volume-outcome-relationships-in-thoracic-surgery
#9
REVIEW
Benjamin D Kozower, George J Stukenborg
Most thoracic surgery studies indicate that hospital and surgeon procedure volume are inversely associated with mortality. However, controversy exists regarding the strength and validity of this volume-outcome association. Because thresholds of procedure volume are used to recommend the regionalization of care, investigation of the volume-outcome relationship is imperative. This article examines the methodology used in the volume-outcome relationship literature and highlights important areas of concern. Careful examination of the literature demonstrates that lung and esophageal cancer resection volume is not strongly associated with mortality and should not be used as a proxy measure for quality...
August 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28647070/national-quality-forum-metrics-for-thoracic-surgery
#10
REVIEW
Anthony Cipriano, William R Burfeind
The National Quality Forum (NQF) is a multistakeholder, nonprofit, membership-based organization improving health care through preferential use of valid performance measures. NQF-endorsed measures are considered the gold standard for health care measurement in the United States. The Society of Thoracic Surgeons is the steward of the only six NQF-endorsed general thoracic surgery measures. These measures include one structure measure (participation in a national general thoracic surgery database), two process measures (recording of clinical stage and recording performance status before lung and esophageal resections), and three outcome measures (risk-adjusted morbidity and mortality after lung and esophageal resections and risk-adjusted length of stay greater than 14 days after lobectomy)...
August 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28647069/oncologic-quality-indicators-in-thoracic-surgery
#11
REVIEW
Jessica Hudson, Tara Semenkovich, Varun Puri
This article outlines a structure for assessing thoracic surgical quality and provides an overview of evidence-based quality metrics for surgical care in both lung cancer and esophageal cancer, with a focus on process and outcome measures in the preoperative, intraoperative, and postoperative setting.
August 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28647068/risk-adjustment-and-performance-measurement-for-esophageal-cancer-resection
#12
REVIEW
Stephanie G Worrell, Andrew C Chang
Achieving high-quality care for all patients undergoing esophageal cancer requires identifying and modifying risk factors associated with poor outcomes. These factors occur at different time points from the preoperative to the postoperative periods. A straightforward model for predicting outcomes has proved difficult to identify. This article reviews the current studies addressing risk adjustment and performance measurement for esophageal cancer resection.
August 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28647067/risk-adjustment-and-performance-measurement-for-lung-cancer-resection
#13
REVIEW
Daniel P Raymond
Comparative audit is an essential tool for multicenter quality efforts. The components include a rigorously defined and collected data source, carefully selected and defined preintervention patient variables that may impact outcome, appropriate risk stratification to aid in comparing varying populations, meticulous outcome selection and analysis, and independent audit to ensure the veracity of the data.
August 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28363379/preface
#14
EDITORIAL
Henning A Gaissert
No abstract text is available yet for this article.
May 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28363378/thoracoplasty-for-tuberculosis-in-the-twenty-first-century
#15
REVIEW
Denis Krasnov, Vladimir Krasnov, Dmitry Skvortsov, Irina Felker
A new modification of osteoplastic collapse thoracoplasty performed with a minimally invasive approach has been proposed. This operation is a variant of extrapleural thoracoplasty used in the treatment of destructive tuberculosis. The benefits of the proposed method, the surgical techniques, and the results of the authors' research are described. Compared with the conventional variant of osteoplastic thoracoplasty, the rates of bacteriologic conversion (odds ratio [OR], 1.84; 95% confidence interval [CI], 1...
May 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28363377/chronic-infections-of-the-chest-wall
#16
REVIEW
Edward J Bergeron, Robert A Meguid, John D Mitchell
Chronic chest wall infections may occur in soft tissue, cartilage, and bone. They may present as localized chest wall pain, a discrete mass initially mistaken for neoplasm, a superficial infection, or a draining sinus. Chronic chest wall infections are typically non-necrotizing and associated with lower morbidity than their more acute and necrotizing counterparts. Effective management of chest wall infections ranges from antimicrobial administration to wide surgical resection and subsequent reconstruction.
May 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28363376/acute-chest-wall-infections-surgical-site-infections-necrotizing-soft-tissue-infections-and-sternoclavicular-joint-infection
#17
REVIEW
Paul Schipper, Brandon H Tieu
Acute chest wall infections are uncommon and share similar risk factors for infection at other surgical sites. Smoking cessation has been shown to decrease the risk of surgical site infection. Depending on the depth of infection and/or involvement of the organ space, adequate therapy involves antibiotics and drainage. Early diagnosis and debridement of necrotizing soft tissue infections is essential to reduce mortality. Sternoclavicular joint infections require surgical debridement, en bloc resection, and antibiotic therapy...
May 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28363375/prosthetic-reconstruction-of-the-chest-wall
#18
REVIEW
Onkar V Khullar, Felix G Fernandez
Large chest wall resections can result in skeletal instability, altered respiratory mechanics, and significant cosmetic defects. Here the authors review a variety of prostheses that can be used to reconstruct these defects, the indications for their use, the technique for implantation, and the available data regarding their clinical outcomes.
May 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28363374/surgical-management-of-lung-cancer-involving-the-chest-wall
#19
REVIEW
Michael Lanuti
The prevalence of chest wall invasion by non-small cell lung cancer is < 10% in published surgical series. The role of radiation or chemotherapy around the complete resection of lung cancer invading the chest wall, excluding the superior sulcus of the chest, is poorly defined. Survival of patients with lung cancer invading the chest wall is dependent on lymph node involvement and completeness of en-bloc resection. In some patients harboring T3N0 disease, 5-year survival in excess of 50% can be achieved. Offering en-bloc resection of lung cancer invading chest wall to patients with T3N1 or T3N2 disease is controversial...
May 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28363373/primary-tumors-of-the-osseous-chest-wall-and-their-management
#20
REVIEW
Mathew Thomas, K Robert Shen
Primary osseous tumors of the chest wall are uncommon neoplasms. They occur in a wide variety of pathologic forms, most of which can be distinguished by unique radiologic appearance. Management of these tumors depends on the diagnosis and stage. Adequate surgical resection is critical in achieving the best outcomes for most of these tumors. Chemotherapy and radiation may have an adjuvant role. Surgeons considering resection of any chest wall tumor should have a sound knowledge of the principles of resection and reconstruction...
May 2017: Thoracic Surgery Clinics
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