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High Volume Hospitals

Zaid Al-Qurayshi, Sudesh Srivastav, Alun Wang, Erin Boh, John Hamner, Mohamed Hassan, Emad Kandil
OBJECTIVE: In this study, we aimed to examine the association of demographic and socioeconomic factors with cutaneous melanoma that required admission. METHODS: A cross-sectional study utilizing the Nationwide Inpatient Sample database, 2003-2009, was merged with County Health Rankings Data. RESULTS: A total of 2,765 discharge -records were included. Men were more likely to have melanoma in the head, neck, and trunk regions (p < 0.001), while extremities melanoma was more common in women (p < 0...
June 18, 2018: Oncology
Ding Xu, Yu Wu, Haibo Shen, Subo Qian, Jun Qi
OBJECTIVE: Assess the association between serum sex hormone level and prostate volume in men with benign prostatic hyperplasia (BPH). MATERIAL AND METHODS: The study involved 239 BPH patients from January 2013 to June 2015 in our hospital. Each patient collected age, medical history, height, weight, body mass index, as well as a full examination of sex hormones, and transrectal ultrasound results. RESULTS: Estradiol (E2) was significantly associated with prostate volume (r = 0...
June 18, 2018: Aging Male: the Official Journal of the International Society for the Study of the Aging Male
Conor P O'Halloran, Peta M A Alexander, Kristofer G Andren, Jessica Mecklosky, Joshua W Salvin, Stephanie Larsen, Jill Zalieckas, Francis Fynn-Thompson, Ravi R Thiagarajan
OBJECTIVES: To quantify and identify factors associated with large RBC exposure in children supported with extracorporeal membrane oxygenation. DESIGN: Retrospective cohort study. SETTING: Single tertiary care children's hospital. PATIENTS: One-hundred twenty-two children supported with extracorporeal membrane oxygenation for greater than 12 hours during January 1, 2015, to December 31, 2016. INTERVENTIONS: None...
June 14, 2018: Pediatric Critical Care Medicine
Natalie J Atkin
For centuries, patients afflicted with the peripheral nerve damaging disease, leprosy-sometimes referred to as Hansen's Disease-were excluded from society and harshly stigmatized. Such stigmatization often stemmed from the belief that the disease was a punishment by G-d for wrongdoing. Leprosy's origins remain rooted throughout various European countries; however, the disease established its presence in North America around the late 18th century. In particular, major port cities that experienced high volume trade, such as New Orleans, were most susceptible to infection...
May 2018: Clinics in Dermatology
Danielle C Sutzko, Elizabeth A Andraska, Andrew A Gonzalez, Apurba K Chakrabarti, Nicholas H Osborne
BACKGROUND: There is a growing interest in providing high quality and low-cost care to Americans. A pursuit exists to measure not only how well hospitals are performing but also at what cost. We examined the variation in costs associated with carotid endarterectomy (CEA), to determine which components contribute to the variation and what drives increased payments. MATERIALS AND METHODS: Patients undergoing CEA between 2009 and 2012 were identified in the Medicare provider and analysis review database...
August 2018: Journal of Surgical Research
Kumpol Amnuaypattanapon, Suwimon Khansompop
Background: The prevalence of hypotension in emergency departments (EDs) is approximately 1-2%, but is associated with a mortality rate of 8-15%. There has never been a study in Thailand examining the epidemiology or the risk factors for early mortality of patients presenting with hypotension in the ED. Therefore, this study aimed to define the characteristics, mortality rate within 48 h and associated factors of hypotensive patients at ED. Methods: Data of patients with hypotension attending the ED of Thammasat University Hospital (TUH) were retrospectively studied...
July 2018: Journal of Clinical Medicine Research
Anne S Chin, Martin J Willemink, Aya Kino, Virginia Hinostroza, Anna M Sailer, Michael P Fischbein, R Scott Mitchell, Gerald J Berry, D Craig Miller, Dominik Fleischmann
BACKGROUND: Limited intimal tears (LITs) of the aorta (Class 3 dissection variant) are the least common form of aortic pathology in patients presenting with acute aortic syndrome (AAS). LITs are difficult to detect on imaging and may be underappreciated. OBJECTIVES: This study sought to describe the frequency, pathology, treatment, and outcome of LITs compared with other AAS, and to demonstrate that LITs can be detected pre-operatively by contemporary imaging. METHODS: The authors retrospectively reviewed 497 patients admitted for 513 AAS events at a single academic aortic center between 2003 and 2012...
June 19, 2018: Journal of the American College of Cardiology
Jingfeng Chen, Leilei Sun, Chonghui Guo, Wei Wei, Yanming Xie
BACKGROUND: A clinical pathway (CP) defines a standardized care process for a well-defined patient group that aims to improve patient outcomes and promote patient safety. However, the construction of a new pathway from scratch is a time-consuming task for medical staff because it involves many factors, including objects, multidisciplinary collaboration, sequential design, and outcome measurements. Recently, the rapid development of hospital information systems has allowed the storage of large volumes of electronic medical records (EMRs), and this information constitutes an abundant data resource for building CPs using data-mining methods...
June 11, 2018: Journal of Biomedical Informatics
Hwi Young Kim, Jeong-Ju Yoo, Sohee Oh, Su Jong Yu, Yoon Jun Kim, Jung-Hwan Yoon, Won Kim, Yong Jin Jung, Bo Hyun Kim, Chang-Min Kim, Joong-Won Park, Jeong-Hoon Lee
Prophylactic antiviral therapy is recommended for hepatitis B virus (HBV)-infected patients with malignancies who are undergoing systemic chemotherapy. In the present study, we aimed to develop a risk scoring system to guide the selection of prophylactic antiviral agents. In this retrospective analysis, we included consecutive chronic hepatitis B patients who received antiviral prophylaxis for chemotherapy of solid or hematologic malignancies at 3 large-volume hospitals in Korea. The primary endpoint was HBV reactivation...
June 13, 2018: Journal of Medical Virology
F Klevebro, C M Scandavini, S Kamiya, M Nilsson, L Lundell, I Rouvelas
Minimally invasive esophagectomy (MIE) has been introduced at many centers worldwide as evidence is accumulating that it reduces the risk of postoperative morbidity and mortality and decreases the length of hospital stay compared to conventional open esophagectomy. The study is a single institution cohort study of 366 consecutive patients treated with curative intent for cancer in the esophagus or gastroesophageal junction, comparing MIE to open surgery. The outcomes studied were peroperative bleeding, operation time, lymph node yield, complications, length of stay and overall survival...
April 20, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Gregory A Joice, Meera R Chappidi, Hiten D Patel, Max Kates, Nikolai A Sopko, C J Stimson, Phillip M Pierorazio, Trinity J Bivalacqua
OBJECTIVES: To investigate the impact of continent urinary diversion on readmissions and hospital costs in a nationally representative sample of radical cystectomies (RC) performed in the United States. MATERIALS & METHODS: The 2010-2014 Nationwide Readmissions Database was queried for patients with a diagnosis of bladder cancer who underwent RC. We identified patients undergoing continent (neobladder or continent cutaneous reservoir) or incontinent (ileal conduit) diversions...
June 13, 2018: BJU International
Akihiko Okamura, Masayuki Watanabe, Ian Fukudome, Kotaro Yamashita, Masami Yuda, Masaru Hayami, Yu Imamura, Shinji Mine
BACKGROUND: Minimally invasive esophagectomy (MIE) is being increasingly performed; however, it is still associated with high morbidity and mortality. The correlation between surgical team proficiency and patient load lacks clarity. This study evaluates surgical outcomes during the first 3-year period after establishment of a new surgical team. METHODS: A new surgical team was established in September 2013 by two expert surgeons having experience of performing more than 100 MIEs...
April 2018: Esophagus: Official Journal of the Japan Esophageal Society
Jun-Qiang Yin, Yi-Wei Fu, Xian-Biao Xie, Xiao-Yu Cheng, Xiao-Yu Yang, Wei-Hai Liu, Jian Tu, Zhen-Hua Gao, Jing-Nan Shen
Background and purpose: Telangiectatic osteosarcoma (TOS), a rare variant of osteosarcoma, may be easily misdiagnosed as aneurysmal bone cyst (ABC). The aims of this study were to investigate the diagnostic and prognostic factors of TOS by reviewing our experience with TOS and to develop a diagnostic model that may distinguish TOS from ABC. Materials and methods: We identified 51 cases of TOS treated at the First Affiliated Hospital of Sun Yat-Sen University from March 2001 to January 2016 and reviewed their records, imaging information and pathological studies...
June 2018: Journal of Bone Oncology
Jason D Wright, Maria P Ruiz, Ling Chen, Lisa R Gabor, Ana I Tergas, Caryn M St Clair, June Y Hou, Cande V Ananth, Alfred I Neugut, Dawn L Hershman
OBJECTIVE: To examine changes over time in surgeon and hospital procedural volume for hysterectomy for endometrial cancer and explore the association between changes in volume and perioperative outcomes. METHODS: We used the Statewide Planning and Research Cooperative System database to analyze women who underwent abdominal or minimally invasive hysterectomy from 2000 to 2014. Annualized surgeon and hospital volume was estimated. The association between surgeon and hospital volume and perioperative morbidity, mortality, and resource utilization (transfusion, length of stay, hospital charges) was estimated by modeling procedural volume as a continuous and categorical variable...
June 6, 2018: Obstetrics and Gynecology
Shitanshu Uppal, Ryan J Spencer, Laurel W Rice, Marcela G Del Carmen, R Kevin Reynolds, Jennifer J Griggs
OBJECTIVE: To evaluate the role of 30-day readmission rate as a quality of care metric in patients undergoing ovarian cancer surgery. METHODS: We performed a retrospective cohort study of women diagnosed between 2004 and 2013 with advanced-stage, high-grade, serous carcinoma who underwent primary treatment. Using the National Cancer Database, we compared the performance of hospital risk-adjusted 30-day readmission rate to other quality of care metrics (risk-adjusted 30- and 90-day mortality, rates of adherence to guideline-based care, and overall survival) within hospitals categorized by yearly case volume (10 or less, 11-20, 21-30, and 31 cases per year or more)...
June 6, 2018: Obstetrics and Gynecology
Kumar Vinchurkar, Vishwanath M Pattanshetti, Manoj Togale, Santosh Hazare, Varadraj Gokak
Currently, pancreaticoduodenectomy (PD) is considered a common and feasibly performed surgery for periampullary tumours, but it is still a high-risk surgical procedure with potential morbidity and mortality rates. Previously, it was emphasised for the need of high-volume centres to perform specialised surgery such as PD. The authors have made an attempt to know the relation between low-volume centre and outcomes of PD. The study was conducted in a Tier-II city referral hospital located in Karnataka, India. A total of 37 patients with suspected periampullary neoplasms underwent surgical exploration with curative intent over a period of 4 years, i...
June 2018: Indian Journal of Surgical Oncology
K L Zhao, J Liu, W N Jiang, J H Hao
Objective: To investigate the prognostic effect of tumour-infiltrating immune cell, including CD8(+) T cell, regulatory T-cell (Treg) and myeloid-derived suppressor cells (MDSC) on pancreatic patients. Methods: This study retrospectively collected the data of 80 patients who were histologically diagnosed of pancreatic cancer and underwent classical R0 surgical resection at Tianjin Medical University Cancer Institute and Hospital from January 2010 to May 2012. All patients survival were followed up until the cut-off date of January 2015...
June 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Young-Ji Seo, Sarah E Rudasill, Yas Sanaiha, Esteban Aguayo, Katherine L Bailey, Vishal Dobaria, Peyman Benharash
BACKGROUND: Thoracic aortic injuries have traditionally been associated with high morbidity and mortality. Thoracic endovascular aortic repair has emerged as a suitable alternative to open repair, but its impact at a national level remains ill defined. This study aimed to analyze the national trends of patient characteristics, outcomes, and resource utilization in the treatment of thoracic aortic injuries. METHODS: Patients admitted with thoracic aortic injuries from 2005-2014 were identified in the National Inpatient Sample...
June 6, 2018: Surgery
Ya-Lien Cheng, Chih-Hsiang Chang, Wei-Ting Chen, Ming-Hung Tsai, Wei-Chen Lee, Kun-Hua Tu, Ya-Chung Tian, Yung-Chang Chen, Cheng-Chieh Hung, Ji-Tseng Fang, Chih-Wei Yang, Ming-Yang Chang
Patients with acute liver failure (ALF) and acute-on-chronic liver failure (ACLF) have a high risk of mortality. Few studies have reported prognostic factors for patients receiving plasma exchange (PE) for liver support. We conducted a retrospective analysis using data of 55 patients with severe ACLF (n = 45) and ALF (n = 10) who received standard-volume PE (1-1.5 plasma volume) in the ICU. Hepatitis B virus infection accounts for the majority of ACLF (87%) and ALF (50%) patients. PE significantly improved the levels of total bilirubin, prothrombin time and liver enzymes (P<0...
June 2, 2018: Transfusion and Apheresis Science
Wiebke Bartels, Simon Adamson, Lisa Leung, Don D Sin, Stephan F van Eeden
Rationale: Readmissions are common following acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and are partially responsible for increased morbidity and mortality in COPD. Numerous factors have been shown to predict readmission of patients previously admitted to hospital for AECOPD; however, factors related to readmission in patients who are triaged in emergency departments (EDs) and sent directly home are poorly understood. We postulate that patients seen in the ED for AECOPD and directly sent home have a high readmission rate, and we suspect that inadequate management and follow-up contribute to this high readmission rate...
2018: International Journal of Chronic Obstructive Pulmonary Disease
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