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Charlson's comorbidity index

Patrick J McCormick, Hung-Mo Lin, Stacie G Deiner, Matthew A Levin
The All Patient Refined Diagnosis Related Group (APR-DRG) is an inpatient visit classification system that assigns a diagnostic related group, a Risk of Mortality (ROM) subclass and a Severity of Illness (SOI) subclass. While extensively used for cost adjustment, no study has compared the APR-DRG subclass modifiers to the popular Charlson Comorbidity Index as a measure of comorbidity severity in models for perioperative in-hospital mortality. In this study we attempt to validate the use of these subclasses to predict mortality in a cohort of surgical patients...
March 22, 2018: Journal of Medical Systems
Inmaculada Arostegui, Nerea Gonzalez, Nerea Fernández-de-Larrea, Santiago Lázaro-Aramburu, Marisa Baré, Maximino Redondo, Cristina Sarasqueta, Susana Garcia-Gutierrez, José M Quintana
Introduction: Colorectal cancer is one of the most frequently diagnosed malignancies and a common cause of cancer-related mortality. The aim of this study was to develop and validate a clinical predictive model for 1-year mortality among patients with colon cancer who survive for at least 30 days after surgery. Methods: Patients diagnosed with colon cancer who had surgery for the first time and who survived 30 days after the surgery were selected prospectively. The outcome was mortality within 1 year...
2018: Clinical Epidemiology
Chad M Myeroff, Jeffrey P Anderson, Daniel S Sveom, Julie A Switzer
Background: Known possible consequences of proximal humerus fractures include impaired shoulder function, decreased independence, and increased risk for mortality. The purpose of this report is to describe the survival and independence of elderly patients with fractures of the proximal humerus, treated in our institution, relative to patient characteristics and treatment method. Methods: Retrospective cohort study from 2006 to 2012. Setting: Community-based hospital with level 1 designation...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Nazanin Abolhassani, Julien Castioni, Valérie Santschi, Gérard Waeber, Pedro Marques-Vidal
BACKGROUND: Polypharmacy (PP) and excessive polypharmacy (EPP) are increasingly common and associated with risk of drug-drug interactions (DDIs). We aimed to measure the trends and determinants of PP and DDIs among patients discharged from the Department of Internal Medicine of the Lausanne University Hospital. METHODS: The retrospective study included 17,742 adult patients discharged between 2009 and 2015. Polypharmacy and EPP were defined as the concomitant prescription of five or more and ten or more drugs, respectively...
March 19, 2018: Journal of Patient Safety
Pooya Banapour, George A Abdelsayed, Zoe Bider-Canfield, Peter A Elliott, Patrick S Kilday, Gary W Chien
To compare perioperative outcomes in the three most common partial nephrectomy modalities: robotic (RPN), laparoscopic (LPN), and open (OPN), matched for nephrometry scores. Patients aged 16-85 who underwent RPN, LPN, or OPN from 2007 to 2014 for localized renal carcinoma within our healthcare system were enrolled. Age, sex, body mass index, and Charlson Comorbidity Index (CCI) as well as perioperative outcomes of estimated blood loss (EBL), length of hospital stay (LOS), ischemia time (IT), change in eGFR, positive margin rate, operative time (OT), and emergency room visit rates were compared between RPN, LPN, and OPN using the R...
March 19, 2018: Journal of Robotic Surgery
Idrees Salam, Jakob Hartvig Thomsen, Jesper Kjaergaard, John Bro-Jeppesen, Martin Frydland, Matilde Winther-Jensen, Lars Køber, Michael Wanscher, Christian Hassager, Helle Søholm
OBJECTIVE: Comorbidity prior to out-of-hospital cardiac arrest (OHCA) and primary rhythm in relation to survival is not well established. We aimed to assess the prognostic importance of comorbidity in relation to primary rhythm in OHCA-patients treated with Target Temperature Management (TTM). DESIGN: Consecutive comatose survivors of OHCA treated with TTM in hospitals in the Copenhagen area between 2002-2011 were included. Utstein-based pre- and in-hospital data collection was performed...
March 19, 2018: Scandinavian Cardiovascular Journal: SCJ
Didier Roulin, Raphaël Girardet, Rafael Duran, Steven Hajdu, Alban Denys, Nermin Halkic, Nicolas Demartines, Emmanuel Melloul
The specific management and outcome of acute biliary pancreatitis in elderly patients is not well established. The aim of this study was to assess the outcome of elderly compared to younger patients after acute biliary pancreatitis. Retrospective analysis of consecutive patients admitted with acute biliary pancreatitis between January 2006 and December 2012. Elderly patients (≥ 70 years) were compared to younger patients (< 70 years) in a case-control study. Comorbidities were assessed according to the Charlson score...
2018: Bioscience Trends
Xiang-Wu Yang, Shai-Hong Zhu, Peng-Zhou Li, Wei-Zheng Li, Xu-Long Sun
PURPOSE: This study aimed to compare the short- and longterm outcomes of elderly and middle-aged patients with gastric cancer who underwent laparoscopic gastrectomy. METHODS: From January 2010 to February 2017, a total of 75 patients with gastric cancer aged ≥70 years (elderly group) underwent laparoscopic gastrectomy, and their short- and long-term outcomes were compared with those of 197 patients with gastric cancer aged 60-69 years (middleaged group) who underwent also laparoscopic gastrectomy during the same period...
January 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Guangyuan Sun, Jun Xue, Yue Zhang, Xiaobin Gao, Fei Guo
PURPOSE: This study aimed to use propensity score matching (PSM) to compare the short- and long-term outcomes of laparoscopic surgery for the treatment of rectal cancer in elderly and middle-aged patients. METHODS: Data were retrospectively obtained from 588 patients aged ≥60 years when they underwent laparoscopic surgery for rectal cancer in our hospital between January 2009 and December 2016. The patients were divided into an elderly group (≥70 years) or a middle-aged group (60-69 years), and were subsequently matched 1:1 using PSM for sex, body mass index, Charlson comorbidity index (CCI), tumor location, clinical stage, and American Society of Anesthesiologists (ASA) score...
January 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Xiaosong Meng, Benjamin Press, Audrey Renson, James S Wysock, Samir S Taneja, William C Huang, Marc A Bjurlin
BACKGROUND: The American Society of Anesthesiologists physical status classification system, modified Charlson Comorbidity Index (mCCI), and modified Frailty Index have been associated with complications after urologic surgery. No study has compared the predictive performance of these indexes for postoperative complications after radical cystectomy (RC) for bladder cancer. MATERIALS AND METHODS: Data from 1516 patients undergoing elective RC for bladder cancer were extracted from the 2005 to 2011 American College of Surgeons National Surgical Quality Improvement Program for a retrospective review...
February 26, 2018: Clinical Genitourinary Cancer
Su Mi Kim, Ho Geun Youn, Ji Yeong An, Yoon Young Choi, Sung Hoon Noh, Seung Jong Oh, Tae Sung Sohn, Sung Kim
PURPOSE: The purpose of this study was to estimate surgical outcomes of elderly patients older than 80 years who received laparoscopic or open gastrectomy for gastric cancer and to identify risk factors for postoperative complications. METHODS: Two hundred forty-two elderly patients older than 80 years underwent gastric cancer surgery between January 2010 and December 2016 in three tertiary hospitals. They were divided into two groups: laparoscopic gastrectomy (N = 59) and open gastrectomy (N = 183)...
March 16, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Anita D Misra-Hebert, Kevin M Pantalone, Xinge Ji, Alex Milinovich, Tanujit Dey, Kevin M Chagin, Janine M Bauman, Michael W Kattan, Robert S Zimmerman
OBJECTIVE: To identify severe hypoglycemia events, defined as emergency department visits or hospitalizations for hypoglycemia, in patients with type 2 diabetes receiving care in a large health system and to identify patient characteristics associated with severe hypoglycemia events. RESEARCH DESIGN AND METHODS: This was a retrospective cohort study from January 2006 to December 2015 using the electronic medical record in the Cleveland Clinic Health System (CCHS)...
March 16, 2018: Diabetes Care
Robert Dziedzic, Tomasz Marjanski, Franciszek Binczyk, Joanna Polanska, Wioletta Sawicka, Witold Rzyman
OBJECTIVES: The video-assisted thoracoscopic surgery (VATS) approach has become a standard for the treatment of early-stage non-small-cell lung cancer (NSCLC). Recently published meta-analyses proved the benefit of VATS versus thoracotomy for overall survival (OS) and reduction of postoperative complications. The aim of this study was to compare early outcomes, long-term survival and rate of postoperative complications of the VATS approach versus thoracotomy. METHODS: In this retrospective cohort study, we analysed 982 individuals who underwent surgical resection for Stage I-IIA NSCLC between 2007 and 2015...
March 14, 2018: European Journal of Cardio-thoracic Surgery
Carol H Wysham, Dominic Pilon, Mike Ingham, Marie-Hélène Lafeuille, Bruno Emond, Rhiannon Kamstra, Michael Pfeifer, Patrick Lefebvre
OBJECTIVE: To compare glycated hemoglobin (HbA1c) control and medication costs between patients with type 2 diabetes mellitus (T2DM) treated with canagliflozin 300 mg (CANA) or a glucagon-like peptide 1 receptor agonist (GLP-1 RA) in a real-world setting. METHODS: Adults with T2DM newly initiated on CANA or a GLP-1 RA (index date) were identified from IQVIA™ Real-World Data Electronic Medical Records U.S. database (March 29, 2012-April 30, 2016). Inverse probability of treatment weighting accounted for differences in baseline characteristics...
March 2018: Endocrine Practice
M Chandran, D Tay, X F Huang, Y Hao
Hospital care and mortality of diabetic and non-diabetic osteoporotic Asian patients undergoing hip fracture surgery were explored with no difference in length of hospitalization, incidence of post-operative complications, or mortality between diabetics and non-diabetics seen. Time to operation correlated with post-operative complications occurrence and therefore surgery should be expeditiously done. INTRODUCTION: Whether burden of inpatient care, problems after admission, and mortality rates differ between diabetics and non-diabetics undergoing surgery for osteoporotic hip fractures has not been explored in Asian populations...
March 15, 2018: Archives of Osteoporosis
Sophia Y Wang, Mariam S Hamid, David C Musch, Maria A Woodward
Importance: Nearly 2 million patients visit emergency departments (EDs) because of eye concerns annually in the United States. How hospitals currently assign these patients to treatment is important for designing systems that equitably allocate resources for eye care in urgent settings. Objective: To investigate factors associated with ophthalmology consultation for eye-related adult ED encounters to assess possible disparities by sex, race/ethnicity, language preference, or residential distance from the medical center...
March 15, 2018: JAMA Ophthalmology
Claire E Raphael, Mandeep Singh, Malcolm Bell, Daniel Crusan, Ryan J Lennon, Amir Lerman, Abhiram Prasad, Charanjit S Rihal, Bernard J Gersh, Rajiv Gulati
BACKGROUND: Women have higher rates of all-cause mortality after percutaneous coronary intervention. Whether this is because of greater age and comorbidity burden or a sex-specific factor remains unclear. METHODS AND RESULTS: We retrospectively assessed cause-specific long-term mortality after index percutaneous coronary intervention over 3 time periods (1991-1997, 1998-2005, and 2006-2012). Cause of death was determined using telephone interviews, medical records, and death certificates...
March 2018: Circulation. Cardiovascular Interventions
Marianna Galeazzi, Paolo Mazzola, Breanna Valcarcel, Giuseppe Bellelli, Marco Dinelli, Giulio Maria Pasinetti, Giorgio Annoni
BACKGROUND: The incidence of biliary tract pathology is growing with an age-related trend, and progresses as the population ages. Endoscopic Retrograde Cholangiopancreatography (ERCP) represents the gold standard for treatment in these cases, but evidence about its safety in the elderly is still debated. METHODS: We retrospectively analyzed the clinical records of all patients aged ≥65 undergoing ERCP between July 2013 and July 2015. Of 387 ERCP cases, 363 (~ 94%) were completed entirely...
March 14, 2018: BMC Gastroenterology
Stephen Clark, Alysa Nash, Mark Shasti, Luke Brown, Julio J Jauregui, Katherine Mistretta, Eugene Koh, Kelley Banagan, Steven Ludwig, Daniel Gelb
STUDY DESIGN: Retrospective cohort study OBJECTIVE.: To assess 30-day and one-year mortality rates as well as the most common complications associated with posterior C1-2 fusion in an octogenarian cohort. SUMMARY OF BACKGROUND DATA: Treatment of unstable type II odontoid fractures in elderly patients can present challenges. Recent evidence indicates in patients older than 80 years, posterior C1-2 fusion results in improved survival as compared to other modes of treatment...
March 13, 2018: Spine
Albert Ariza-Solé, Carme Guerrero, Francesc Formiga, Jaime Aboal, Emad Abu-Assi, Francisco Marín, Héctor Bueno, Oriol Alegre, Ramón López-Palop, María T Vidán, Manuel Martínez-Sellés, Pablo Díez-Villanueva, Pau Vilardell, Alessandro Sionis, Miquel Vives-Borrás, Juan Sanchís, Jordi Bañeras, Agnès Rafecas, Cinta Llibre, Javier López, Violeta González-Salvado, Àngel Cequier
BACKGROUND:  Bleeding risk scores have shown a limited predictive ability in elderly patients with acute coronary syndromes (ACS). No study explored the role of a comprehensive geriatric assessment to predict in-hospital bleeding in this clinical setting. METHODS:  The prospective multicentre LONGEVO-SCA registry included 532 unselected patients with non-ST segment elevation ACS (NSTEACS) aged 80 years or older. Comorbidity (Charlson index), frailty (FRAIL scale), disability (Barthel index and Lawton-Brody index), cognitive status (Pfeiffer test) and nutritional risk (mini nutritional assessment-short form test) were assessed during hospitalization...
March 2018: Thrombosis and Haemostasis
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