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High Volume Hospitals

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https://www.readbyqxmd.com/read/29684373/racial-disparity-in-utilization-of-high-volume-hospitals-for-surgical-treatment-of-esophageal-cancer
#1
Sadiq S Rehmani, Bian Liu, Adnan Al-Ayoubi, Wissam Raad, Raja M Flores, Faiz Bhora, Emanuela Taioli
BACKGROUND: Utilization of high-volume hospitals (HVH) for esophagectomy has been associated with improved perioperative outcomes and reduced mortality. We aimed to test the hypothesis that black-white racial disparities exist in HVH utilization, and to identify predictors of in-hospital surgical outcomes of esophageal cancer while adjusting for HVH utilization patterns. METHODS: We queried the New York Statewide Planning and Research Cooperative System (SPARCS) database (1995-2012) for esophageal cancer patients who underwent surgical resection exclusively...
April 20, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29683748/fit-for-purpose-evaluation-of-cpd-courses-for-nurses-in-an-irish-university-teaching-hospital
#2
Mary Ryder, Freda Browne, Cáit Galvin, Orla Leonard, Jody O'Reilly
INTRODUCTION: acute tertiary hospitals require knowledgeable, skilled registered nurses to care for patients in specialist areas. It is also a professional responsibility that nurses maintain skills and competence. This article reports on stage 1 of an action research study to evaluate the delivery of continuing professional development (CPD) courses for registered nurses in an acute hospital in Ireland. METHODS: an audit and qualitative self-reporting questionnaire was used to obtain data...
April 26, 2018: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29682212/relationship-between-hospital-volume-and-short-term-outcomes-a-nationwide-population-based-study-including-75-280-rectal-cancer-surgical-procedures
#3
Salvatore Pucciarelli, Manuel Zorzi, Nicola Gennaro, Francesco Marchegiani, Andrea Barina, Massimo Rugge, Matteo Zuin, Alessandro Perin, Isacco Maretto, Francesca Bergamo, Caterina Boso, Emanuele Damiano Luca Urso, Patrick Frambach, Maria Chiara Corti
There is growing interest on the potential relationship between hospital volume (HV) and outcomes as it might justify the centralization of care for rectal cancer surgery. From the National Italian Hospital Discharge Dataset, data on 75,280 rectal cancer patients who underwent elective major surgery between 2002 and 2014 were retrieved and analyzed. HV was grouped into tertiles: low-volume performed 1-12, while high-volume hospitals performed 33+ procedures/year. The impact of HV on in-hospital mortality, abdominoperineal resection (APR), 30-day readmission, and length of stay (LOS) was assessed...
March 30, 2018: Oncotarget
https://www.readbyqxmd.com/read/29681581/prognostic-value-of-the-8-th-edition-of-the-tumor-node-metastasis-classification-for-patients-with-papillary-thyroid-carcinoma-a-single-institution-study-at-a-high-volume-center-in-japan
#4
Yasuhiro Ito, Akira Miyauchi, Mitsuyoshi Hirokawa, Masatoshi Yamamoto, Hitomi Oda, Hiroo Masuoka, Hisanori Sasai, Mitsuhiro Fukushima, Takuya Higashiyama, Minoru Kihara, Akihiro Miya
The tumor-node-metastasis (TNM) staging system is most commonly adopted to evaluate the prognosis of patients with thyroid carcinoma. The 8th edition of the TNM staging system, an extensively revised version of the 7th edition, was recently released. We aimed to investigate whether and how well the 8th edition reflects the cause-specific survival (CSS) of patients with papillary thyroid carcinoma by analyzing the cases in 5,892 patients who underwent initial surgery at Kuma Hospital between 1987 and 2005. The median postoperative follow-up duration was 178 months (range: 6-357 months)...
April 20, 2018: Endocrine Journal
https://www.readbyqxmd.com/read/29677082/artificial-intelligence-can-predict-daily-trauma-volume-and-average-acuity
#5
David P Stonko, Bradley M Dennis, Richard D Betzold, Allan B Peetz, Oliver L Gunter, Oscar D Guillamondegui
INTRODUCTION: The goal of this study was to integrate temporal and weather data in order to create an artificial neural network (ANN) to predict trauma volume, the number of emergent operative cases, and average daily acuity at a level 1 trauma center. METHODS: Trauma admission data from TRACS and weather data from the National Oceanic and Atmospheric Administration (NOAA) was collected for all adult trauma patients from July 2013-June 2016. The ANN was constructed using temporal (time, day of week), and weather factors (daily high, active precipitation) to predict four points of daily trauma activity: number of traumas, number of penetrating traumas, average ISS, and number of immediate OR cases per day...
April 19, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29676679/principles-of-system-design-not-realized-for-pediatric-craniospinal-trauma-care-in-the-united-states
#6
Joseph Piatt
OBJECTIVE An implicit expectation of the pioneers of trauma system design was that high clinical volume at select centers could lead to superior outcomes. There has been little study of the regionalization of pediatric craniospinal trauma care, and whether it continues to trend in the direction of regionalization is unknown. The motivating hypothesis for this study was that trauma system design in the United States is proceeding on a rational basis, producing hospital caseloads that are increasing over time and, because of geographic siting appropriate to the needs of catchment areas, in an increasingly uniform manner...
April 20, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29674757/ten-initial-cases-of-peroral-endoscopic-myotomy-for-treatment-of-esophageal-motility-disorders-at-okayama-university-hospital
#7
Yuusaku Sugihara, Keita Harada, Ryo Kato, Kenji Yamauchi, Shiho Takashima, Daisuke Takei, Yasushi Yamasaki, Toshihiro Inokuchi, Masahiro Takahara, Sakiko Hiraoka, Hiroyuki Okada
Peroral endoscopic myotomy (POEM) for treatment of esophageal motility disorders has recently been reported to be highly effective and less invasive than other treatment. POEM was recently introduced in Okayama University Hospital under the supervision of a physician from a high-volume center. To verify the safety and efficacy of POEM during its introduction in our institution. We examined 10 cases in whom POEM was performed between January 2016 and April 2017. The patients included 7 men and 3 women, with a median age (range) of 49 years (17-74) and median symptom duration of 6 years (1-21)...
April 2018: Acta Medica Okayama
https://www.readbyqxmd.com/read/29672526/structured-patient-handoff-on-an-internal-medicine-ward-a-cluster-randomized-control-trial
#8
Penny Tam, Aman P Nijjar, Mark Fok, Chris Little, Alexandra Shingina, Jesse Bittman, Rashmi Raghavan, Nadia A Khan
BACKGROUND: The effect of a multi-faceted handoff strategy in a high volume internal medicine inpatient setting on process and patient outcomes has not been clearly established. We set out to determine if a multi-faceted handoff intervention consisting of education, standardized handoff procedures, including fixed time and location for face-to-face handoff would result in improved rates of handoff compared with usual practice. We also evaluated resident satisfaction, health resource utilization and clinical outcomes...
2018: PloS One
https://www.readbyqxmd.com/read/29672335/the-impact-of-surgical-volume-on-outcomes-and-cost-in-cleft-repair-a-kids-inpatient-database-analysis
#9
Alexandra Bucknor, Anmol Chattha, Winona Wu, Sabine Egeler, Klaas Ultee, Salim Afshar, Samuel J Lin
BACKGROUND: Centralization of specialist services, including cleft service delivery, is occurring worldwide with the aim of improving the outcomes. This study examines the relationship between hospital surgical volume in cleft palate repair and outcomes. METHODS: A retrospective analysis of the Kids' Inpatient Database was undertaken. Children 3 years or younger undergoing cleft palate repair in 2012 were identified. Hospital volume was categorized by cases per year as low volume (LV; 0-14), intermediate volume (IV; 15-46), or high volume (HV; 47-99); differences in complications, hospital costs, and length of stay (LOS) were determined by hospital volume...
April 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29672208/evisceration-with-autogenous-scleral-graft-and-bioceramic-implantation-within-the-modified-scleral-shell-133-cases-over-17-years
#10
Jeremy Nadal, Vincent Daien, Jérôme Jacques, Didier Hoa, Frederic Mura, Max Villain
INTRODUCTION: To present long-term follow-up data on evisceration performed with autogenous scleral grafting and ceramic implantation in a modified scleral shell. METHODS: This was a retrospective analysis of all consecutive eviscerations performed in the Department of Ophthalmology, Montpellier University Hospital, France, between February 1998 and October 2015. For all patients, the technique used was a conventional anterior evisceration after total keratectomy, disinsertion of the medial rectus muscle, sectioning of the optic nerve and excision of sclera centered on the papilla...
April 19, 2018: Orbit
https://www.readbyqxmd.com/read/29668913/defining-pneumonia-after-esophagectomy-for-cancer-validation-of-the-uniform-pneumonia-score-in-a-high-volume-center-in-north-america
#11
M F J Seesing, A Wirsching, P S N van Rossum, T J Weijs, J P Ruurda, R van Hillegersberg, D E Low
Surgery is a central component of multimodality therapy for esophageal and gastroesophageal junction cancer. Pneumonia is a common sequela of esophagectomy, leading to an increase in intensive care unit stay, hospital stay, readmission rates, and postoperative mortality. Developing strategies to reduce pneumonia after esophagectomy is hampered by the absence of a standardized methodology for defining pneumonia. This study aims to validate the Uniform Pneumonia Score (UPS) in a high volume center in the USA...
April 14, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29668502/transcatheter-aortic-valve-replacement-efficiency-and-safety-improvements-with-progressive-experience-and-improved-technology
#12
Seyed Hossein Aalaei-Andabili, R David Anderson, Anthony A Bavry, Teng C Lee, Siddharth Wayangankar, George J Arnaoutakis, Thomas M Beaver
OBJECTIVE: Transcatheter aortic valve replacement is now commercially available for intermediate-risk, high-risk, or inoperable patients with severe aortic stenosis. In this study, we investigated change in the safety and efficiency of the transcatheter aortic valve replacement procedure at our institution and patient outcomes comparing our first 100, second 100, and last 100 patients. METHODS: From March 2012 to June 2016, 544 patients underwent transcatheter aortic valve replacement at our center...
April 17, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29666028/evidence-based-thresholds-for-the-volume-and-cost-relationship-in-total-hip-arthroplasty-outcomes-and-economies-of-scale
#13
Heather S Haeberle, Sergio M Navarro, William C Frankel, Michael A Mont, Prem N Ramkumar
BACKGROUND: High-volume surgeons and hospital systems have been shown to deliver higher-value care in several studies. However, no evidence-based volume thresholds for cost currently exist in total hip arthroplasty (THA). The objective of this study was to establish meaningful thresholds in cost for surgeons and hospitals performing THA. A secondary objective was to analyze the market share of THAs for each surgeon and hospital stratifications. METHODS: Using a database of 136,501 patients undergoing THA, we used stratum-specific likelihood ratio analysis of a receiver operating characteristic curve to generate volume thresholds based on costs for surgeons and hospitals...
March 15, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29664883/should-all-orthopedists-perform-hemiarthroplasty-for-femoral-neck-fractures-a-volume-outcome-analysis
#14
R Carter Clement, Paula D Strassle, Robert F Ostrum
OBJECTIVES: To determine whether very low surgeon and hospital hip arthroplasty volume are associated with unfavorable outcomes following hemiarthroplasty for femoral neck fractures. METHODS: Patients ≥60 years old and who underwent hemiarthroplasty for femoral neck fracture were identified in the New York Statewide Planning and Research Cooperative System data from 2001-2015. Incidence of inpatient mortality and postoperative complications were compared across both surgeon and hospital volume using multivariable Cox proportional hazards regression, adjusting for clinical and demographic factors...
April 3, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29664502/hospital-acquired-hyponatremia-does-the-type-of-fluid-therapy-affect-children-admitted-to-intensive-care
#15
Pilar Velasco, Andrés J Alcaraz, Niki Oikonomopoulou, Marina Benito, Raquel Moya, Álvaro Sánchez
INTRODUCTION: The objective of this study was to evaluate the association between the type of initial fluid therapy used (isotonic or hypotonic solutions) and the development of hyponatremia, the plas ma chlorine values and the tolerance of venous access. PATIENTS AND METHOD: Retrospective cohort study in a Pediatric Intensive Care Unit (PICU) of a high complexity hospital. There were included children younger than 15 years old hospitalized during the first semester of 2010 and 2013 who recei ved intravenous maintenance fluid therapy, excluding patients undergoing cardiac surgery, kidney transplant and admissions that lasted less than 24 hours...
February 2018: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/29661444/single-and-double-lung-transplantation-results-of-an-initial-experience-of-39-cases-in-cear%C3%A3-northeast-brazil
#16
A Gomes Neto, A S Monteiro Nogueira, I Lopes De Medeiros, R Fernandes Viana De Araujo, R Carvalho Santos, C M Sampaio Viana, F Moreira Batista Aguiar, L Gomes Catunda, L Araújo Aragão, R Fava Alencar
INTRODUCTION: The lung transplantation (LTx) program began in Ceará in 2011 and the first LTx was performed on June 11, 2011. The aim of this study was to present the initial results of the 6-year experience of our program. METHODS: We retrospectively reviewed our experience on LTx from June 2011 to August 2017. Data on recipients and transoperative and postoperative outcomes were recorded in a database. RESULTS: Twenty-two (56.4%) were single LTx, 15 (38...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29658666/-application-of-modified-lateral-window-for-maxillary-sinus-floor-augmentation
#17
Wei Lu, Mengna Lin, Shifang Zhao, Huiming Wang, Fuming He
<b>Objective:</b> To evaluate the clinical efficacy of modified lateral window for maxillary sinus floor augmentation (MSFA). <b>Methods:</b> Fifty-five patients who visited the Stomatology Hospital Affiliated to Zhejiang University School of Medicine between June 2012 and October 2014 were enrolled in the study. Patients underwent MSFA with Bio-Oss grafts based on modified access window. During the operation the vertical height of the bony window was reduced from 6-8 mm of conventional oval window to 4-5 mm of slot-shaped window...
May 25, 2017: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
https://www.readbyqxmd.com/read/29655822/clinical-spectrum-and-management-of-heart-failure-in-hypertrophic-cardiomyopathy
#18
REVIEW
Barry J Maron, Ethan J Rowin, James E Udelson, Martin S Maron
Heart failure (HF), characterized by excessive exertional dyspnea, is a common complication within the broad clinical spectrum of hypertrophic cardiomyopathy (HCM). HF has become an increasingly prominent management issue with the reduction in sudden deaths due to use of implantable defibrillators in this disease. Exertional dyspnea ranges in severity from mild to severe (New York Heart Association functional classes II to IV) and not uncommonly becomes refractory to medical management, leading to progressive disability, but largely in the absence of pulmonary congestion and volume overload requiring hospitalization...
April 5, 2018: JACC. Heart Failure
https://www.readbyqxmd.com/read/29652941/observed-to-expected-or-logistic-regression-to-identify-hospitals-with-high-or-low-30-day-mortality
#19
Doris Tove Kristoffersen, Jon Helgeland, Jocelyne Clench-Aas, Petter Laake, Marit B Veierød
INTRODUCTION: A common quality indicator for monitoring and comparing hospitals is based on death within 30 days of admission. An important use is to determine whether a hospital has higher or lower mortality than other hospitals. Thus, the ability to identify such outliers correctly is essential. Two approaches for detection are: 1) calculating the ratio of observed to expected number of deaths (OE) per hospital and 2) including all hospitals in a logistic regression (LR) comparing each hospital to a form of average over all hospitals...
2018: PloS One
https://www.readbyqxmd.com/read/29652082/association-between-hospital-volume-and-quality-of-gastric-cancer-surgery-in-the-critics-trial
#20
Y H M Claassen, J W van Sandick, H H Hartgrink, J L Dikken, W O De Steur, N C T van Grieken, H Boot, A Cats, A K Trip, E P M Jansen, W M Meershoek-Klein Kranenbarg, J P B M Braak, H Putter, M I van Berge Henegouwen, M Verheij, C J H van de Velde
BACKGROUND: Studies investigating the association between hospital volume and quality of gastric cancer surgery are lacking. In the present study, the effect of hospital volume on quality of gastric cancer surgery was evaluated by analysing data from the CRITICS (ChemoRadiotherapy after Induction chemotherapy In Cancer of the Stomach) trial. METHODS: Patients who underwent gastrectomy with curative intent in the Netherlands were selected from the CRITICS trial database...
May 2018: British Journal of Surgery
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