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Charlson's comorbidity index

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https://www.readbyqxmd.com/read/28922625/living-and-dying-with-advanced-dementia-a-prospective-cohort-study-of-symptoms-service-use-and-care-at-the-end-of-life
#1
Elizabeth L Sampson, Bridget Candy, Sarah Davis, Anna Buylova Gola, Jane Harrington, Michael King, Nuriye Kupeli, Gerry Leavey, Kirsten Moore, Irwin Nazareth, Rumana Z Omar, Victoria Vickerstaff, Louise Jones
BACKGROUND: Increasing number of people are dying with advanced dementia. Comfort and quality of life are key goals of care. AIMS: To describe (1) physical and psychological symptoms, (2) health and social care service utilisation and (3) care at end of life in people with advanced dementia. DESIGN: 9-month prospective cohort study. SETTING AND PARTICIPANTS: Greater London, England, people with advanced dementia (Functional Assessment Staging Scale 6e and above) from 14 nursing homes or their own homes...
August 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28922281/systematic-changes-in-the-national-surgical-quality-improvement-program-database-over-the-years-can-affect-comorbidity-indices-such-as-the-modified-frailty-index-and-modified-charlson-comorbidity-index-for-lumbar-fusion-studies
#2
Blake N Shultz, Taylor D Ottesen, Nathaniel T Ondeck, Patawut Bovonratwet, Ryan P McLynn, Jonathan J Cui, Jonathan N Grauer
STUDY DESIGN: Retrospective cohort study of prospectively collected data. OBJECTIVE: To investigate the influence of changes in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database over the years on the calculation of the modified Frailty Index (mFI) and the modified Charlson Comorbidity Index (mCCI) for posterior lumbar fusion studies. SUMMARY OF BACKGROUND DATA: Multiple studies have utilized the mFI and/or mCCI and showed them to be predictors of adverse postoperative outcomes...
September 15, 2017: Spine
https://www.readbyqxmd.com/read/28920421/endoscopic-retrograde-cholangiopancreatography-in-nonagenarian-patients-is-it-really-safe
#3
Zain A Sobani, Daria Yunina, Anna Abbasi, Kevin Tin, Daniel Simkin, Mary Rojas, Yuriy Tsirlin, Ira Mayer, Rabin Rahmani
Background/Aims: Literature on the safety of endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients is divided. Based on this we decided to examine the safety of ERCP in nonagenarian patients. Methods: A total of 1,389 patients, with a mean age of 63.94±19.62 years, underwent ERCP during the study period. There were 74 patients aged 90 years or older with a mean age of 92.07±1.8. Logistic regression showed that nonagenarian patients had a significantly increased odds of in-patient mortality (adjusted odds ratio [AOR]=9...
September 18, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28919978/controlled-substance-agreements-for-opioids-in-a-primary-care-practice
#4
Lindsey M Philpot, Priya Ramar, Muhamad Y Elrashidi, Raphael Mwangi, Frederick North, Jon O Ebbert
BACKGROUND: Opioids are widely prescribed for chronic non cancer pain (CNCP). Controlled substance agreements (CSAs) are intended to increase adherence and mitigate risk with opioid prescribing. We evaluated the demographic characteristics of and opioid dosing for patients with CNCP enrolled in CSAs in a primary care practice. METHODS: We conducted a retrospective cohort study of 1066 patients enrolled in CSAs between May 9, 2013 and August 15, 2016 for CNCP in a Midwest primary care practice...
2017: Journal of Pharmaceutical Policy and Practice
https://www.readbyqxmd.com/read/28919283/clinical-manifestations-risk-factors-and-prognosis-of-patients-with-morganella-morganii-sepsis
#5
David Erlanger, Marc Victor Assous, Yonit Wiener-Well, Amos Moshe Yinnon, Eli Ben-Chetrit
BACKGROUND: There are few studies of Morganella bacteremia. We evaluated risk factors and outcome of patients with Morganella bacteremia. METHODS: Medical records of patients with Morganella bacteremia were reviewed (1997-2014). Control group patients with Escherichiacoli sepsis were matched by year of diagnosis and infection acquisition site. RESULTS: The study group included 136 adult patients. Mean age and gender of study and control groups were similar...
September 6, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28918401/return-to-work-and-lost-earnings-after-acute-respiratory-distress-syndrome-a-5-year-prospective-longitudinal-study-of-long-term-survivors
#6
Biren B Kamdar, Kristin A Sepulveda, Alexandra Chong, Robert K Lord, Victor D Dinglas, Pedro A Mendez-Tellez, Carl Shanholtz, Elizabeth Colantuoni, Till M von Wachter, Peter J Pronovost, Dale M Needham
BACKGROUND: Delayed return to work is common after acute respiratory distress syndrome (ARDS), but has undergone little detailed evaluation. We examined factors associated with the timing of return to work after ARDS, along with lost earnings and shifts in healthcare coverage. METHODS: Five-year, multisite prospective, longitudinal cohort study of 138 2-year ARDS survivors hospitalised between 2004 and 2007. Employment and healthcare coverage were collected via structured interview...
September 16, 2017: Thorax
https://www.readbyqxmd.com/read/28917110/prevalence-and-predictors-of-potentially-inappropriate-prescribing-of-central-nervous-system-and-psychotropic-drugs-among-elderly-patients-a-national-population-study-in-korea
#7
Hyeonseok Cho, Junjeong Choi, Young-Sang Kim, Sang Joon Son, Kang Soo Lee, Hee-Jin Hwang, Hye-Young Kang
OBJECTIVES: To investigate the prevalence of potentially inappropriate prescribing (PIP) of central nervous system and psychotropic (CNS-PS) drugs to the Korean elderly population, and to identify PIP-associated factors. METHODS: Ambulatory care visits were identified from the 2013 National Aged Patient Sample (HIRA-APS-2013) data, composed of 20% random samples of all enrollees in the universal health security program aged ≥65 years. The CNS-PS section of Screening Tool of Older Person's potentially inappropriate Prescriptions (STOPP) criteria version 2 was used to identify PIP at these visits...
September 6, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28916548/do-comorbidities-play-a-role-in-hand-osteoarthritis-disease-burden-data-from-the-hand-osteoarthritis-in-secondary-care-cohort
#8
Wendy Damman, Rani Liu, Féline P B Kroon, Monique Reijnierse, Tom W J Huizinga, Frits R Rosendaal, Margreet Kloppenburg
OBJECTIVE: Because the association and its clinical relevance between comorbidities and primary hand osteoarthritis (OA) disease burden is unclear, we studied this in patients with hand OA from our Hand OSTeoArthritis in Secondary care (HOSTAS) cohort. METHODS: Cross-sectional data from the HOSTAS study were used, including consecutive patients with primary hand OA. Nineteen comorbidities were assessed: 18 self-reported (modified Charlson index and osteoporosis) and obesity (body mass index ≥ 30 kg/m(2))...
September 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28916510/outcomes-of-telemedicine-video-conferencing-clinic-versus-in-person-clinic-follow-up-for-implantable-cardioverter-defibrillator-recipients
#9
Khidir Dalouk, Nainesh Gandhi, Peter Jessel, Karen MacMurdy, Ignatius Gerardo Zarraga, Michael Lasarev, Merritt Raitt
BACKGROUND: Implantable cardioverter-defibrillator (ICD) recipients require close follow-up that can be difficult for patients who have to travel long distances for clinic follow-up. We aimed to compare clinical outcomes between ICD patients followed-up in a telemedicine video-conferencing clinic (TMVC) and a conventional in-person clinic (CIC). We hypothesized that outcomes of patients followed in the TMVC are noninferior to the CIC. METHODS AND RESULTS: This retrospective study compares time to first appropriate ICD therapy, time to first inappropriate ICD therapy, time to first shock, and overall survival in patients followed in TMVC compared with CIC between 2001 and 2016...
September 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28914694/the-association-of-nonalcoholic-steatohepatitis-and-obstructive-sleep-apnea
#10
Mohammad M Asfari, Fadi Niyazi, Rocio Lopez, Srinivasan Dasarathy, Arthur J McCullough
BACKGROUND AND AIM: The association between obstructive sleep apnea (OSA) and abnormal liver enzymes has been reported in multiple studies. The existing literature regarding the relationship between OSA and nonalcoholic steatohepatitis (NASH) is conflicting. Thus we aimed to determine the relationship between OSA and NASH from a large database. PATIENTS AND METHODS: A cross-sectional study was performed using the 2012 Nationwide Inpatient Sample. We identified adult patients (18-90 years) who had a diagnosis of OSA using the International Classification of Diseases 9th version codes...
September 13, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28912636/should-emergency-endoscopy-be-performed-in-all-patients-with-suspected-colonic-diverticular-hemorrhage
#11
Takeshi Uehara, Satohiro Matsumoto, Hiroyuki Miyatani, Hirosato Mashima
OBJECTIVE: We attempted to develop a scoring system for facilitating decision making regarding the performance of emergency endoscopy in patients with colonic diverticular hemorrhage. METHODS: This study involved analysis of the data of 178 patients who presented with hematochezia and were diagnosed as having colonic diverticular hemorrhage by colonoscopy. The patients were divided into 2 groups depending on whether the bleeding source was identified or not at the initial endoscopy (source-identified and source-not-identified groups), and on the basis of the results obtained, we established a scoring system for predicting successful identification of the bleeding source...
2017: Clinical Medicine Insights. Gastroenterology
https://www.readbyqxmd.com/read/28903447/locoregionally-recurrent-head-and-neck-squamous-cell-carcinoma-incidence-survival-prognostic-factors-and-treatment-outcomes
#12
Jer-Hwa Chang, Chia-Che Wu, Kevin Sheng-Po Yuan, Alexander T H Wu, Szu-Yuan Wu
PURPOSE: For locoregionally recurrent head and neck squamous cell carcinoma (HNSCC), appropriate therapeutic decisions remain unclear. We examined the treatment outcomes of a national cohort to determine suitable treatments for and prognostic factors in patients with locoregionally recurrent HNSCCs at different stages and sites. PATIENTS AND METHODS: We analyzed data of >20-year-old patients with HNSCC at American Joint Committee on Cancer clinical stages I-IV without metastasis from Taiwan National Health Insurance and cancer registry databases...
August 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28898377/association-between-laparoscopic-antireflux-surgery-and-recurrence-of-gastroesophageal-reflux
#13
John Maret-Ouda, Karl Wahlin, Hashem B El-Serag, Jesper Lagergren
Importance: Cohort studies, mainly based on questionnaires and interviews, have reported high rates of reflux recurrence after antireflux surgery, which may have contributed to a decline in its use. Reflux recurrence after laparoscopic antireflux surgery has not been assessed in a long-term population-based study of unselected patients. Objectives: To determine the risk of reflux recurrence after laparoscopic antireflux surgery and to identify risk factors for recurrence...
September 12, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28894902/development-and-validation-of-a-medicines-comorbidity-index-for-older-people
#14
Sujita W Narayan, Prasad S Nishtala
PURPOSE: An index for estimating multimorbidity based on prescription claims data is important for predicting health outcomes for older people in pharmacoepidemiological studies. We aimed to develop a Medicines Comorbidity Index (MCI) based on nationwide prescription claims data and evaluate its performance in predicting adverse outcomes in older individuals. METHODS: The index was developed on a retrospective cohort comprising of all individuals aged ≥ 65 years old, captured in the claims dataset from 1st January to 31st December 2012...
September 11, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28893226/effect-of-periodontitis-on-the-development-of-osteoporosis-results-from-a-nationwide-population-based-cohort-study-2003-2013
#15
Jung-Kyu Choi, Young-Taek Kim, Hye-In Kweon, Eun-Cheol Park, Seong-Ho Choi, Jae-Hong Lee
BACKGROUND: The prevalence of osteoporosis associated with the aging process is anticipated to increase along with the rising aging population. Periodontitis that the most common chronic infections of humankind is considered the risk factor for osteoporosis. The aim of this study was to identify the association between osteoporosis and periodontitis using a population-based cohort. METHODS: The case group was defined as patients diagnosed with periodontitis and treated with subgingival curettage, root conditioning, periodontal flap operation, bone grafting for alveolar bone defects, and guided tissue regeneration...
September 11, 2017: BMC Women's Health
https://www.readbyqxmd.com/read/28889162/meaningful-functional-change-achieved-from-physical-therapy-provided-in-a-student-run-pro-bono-clinic
#16
Suzanne R O'Brien, Melissa Bulas, Alexander Metcalfe, Zachary Mix, Todd Richert, Richard Wagner
OBJECTIVE: This study investigated whether patients with chronic neurologic diagnoses who attended a student-run pro bono physical therapy (PT) clinic achieved the minimum detectable change (MDC) on functional measures and the factors associated with such change. METHODS: Retrospective chart review included 71 patients with a primary diagnosis of stroke, traumatic brain injury, or multiple sclerosis from 2010 to 2014. The sample was 45% female, with a mean age of 62 yrs (SD 12...
2017: Journal of Allied Health
https://www.readbyqxmd.com/read/28885936/vancomycin-vs-vancomycin-piperacillin-tazobactam-associated-acute-kidney-injury-in-noncritically-ill-patients-at-a-tertiary-care-military-treatment-facility
#17
Caleb W Anderson, Kathy S Cazares, Michael B Lustik, Shivam M Patel, Troy M Denunzio
BACKGROUND: Broad-spectrum antibiotics are often used as initial empiric therapy in patients at risk for infections by multidrug-resistant organisms. Emerging literature and anecdotal reports within Tripler Army Medical Center indicate an increased incidence of vancomycin-associated acute kidney injury when used in combination with piperacillin-tazobactam. This is a retrospective, single-center study comparing the incidence of acute kidney injury in noncritically ill patients receiving either vancomycin or vancomycin in combination with piperacillin-tazobactam in a 206-bed tertiary care military training facility...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28885373/age-adjusted-charlson-comorbidity-score-is-associated-with-the-risk-of-empyema-in-patients-with-copd
#18
Chung-Han Ho, Yi-Chen Chen, Chin-Chen Chu, Jhi-Joung Wang, Kuang-Ming Liao
Patients with chronic obstructive pulmonary disease (COPD) have a higher risk of pneumonia than the general population due to their impaired lung defense. They also have a higher risk of empyema and more comorbidities than patients without COPD. This study aimed to evaluate the risk of empyema in patients with COPD after adjusting for age and comorbidities using the age-adjusted Charlson comorbidity index (ACCI).Data were retrieved from the National Health Insurance Research Database. COPD patients were defined as inpatients aged >40 years with an International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code for COPD...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28885288/early-effects-of-medicare-s-bundled-payment-for-care-improvement-bpci-program-for-lumbar-fusion
#19
Brook I Martin, Jon D Lurie, Farrokh R Farrokhi, Kevin J McGuire, Sohail K Mirza
STUDY DESIGN: Retrospective analysis of Medicare claims linked to hospital participation in the Center for Medicare and Medicaid Innovation's episode-based Bundled Payment for Care Improvement (BPCI) program for lumbar fusion. OBJECTIVES: To describe the early effects of BPCI participation for lumbar fusion on 90-day reimbursement, procedure volume, reoperation, and readmission. SUMMARY OF BACKGROUND DATA: Initiated on January 1st, 2013, BPCI's voluntary bundle payment program provides a predetermined payment for services related to a Diagnosis Related Group-defined "triggering event" over a defined time period...
September 6, 2017: Spine
https://www.readbyqxmd.com/read/28882110/serum-osteoprotegerin-in-prevalent-hemodialysis-patients-associations-with-mortality-atherosclerosis-and-cardiac-function
#20
Sílvia Collado, Elisabeth Coll, Carlos Nicolau, Manel Azqueta, Mercedes Pons, Josep M Cruzado, Bernat de la Torre, Ramón Deulofeu, Sergi Mojal, Julio Pascual, Aleix Cases
BACKGROUND: To assess whether serum osteoprotegerin (OPG) and/or fetuin-A predict mortality and cardiovascular (CV) morbidity and mortality in hemodialysis patients. METHODS: Multicenter, observational, prospective study that included 220 hemodialysis patients followed up for up to 6 years. Serum OPG and fetuin-A levels were measured at baseline and their possible association with clinical characteristics, CV risk biomarkers, carotid ultrasonographic findings, as well as their association with overall and CV mortality and CV events were assessed...
September 7, 2017: BMC Nephrology
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