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High Volume Hospitals

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https://www.readbyqxmd.com/read/29040130/volume-outcome-relationship-in-surgical-interventions-for-spinal-metastases
#1
Andrew J Schoenfeld, Marco L Ferrone, Daniel J Sturgeon, Mitchel B Harris
BACKGROUND: Surgery for spinal metastases is challenging and carries a high risk of perioperative morbidity and mortality. Procedures with such characteristics often exhibit a volume-outcome relationship. This has not been previously characterized for spinal metastasis surgery to our knowledge. METHODS: The Florida State Inpatient Database (2011 through 2014) was queried to identify patients who had undergone surgery for spinal metastases. Surgeon and hospital surgical volumes were compared with 90-day complication and readmission rates to develop procedural cut-points used to define high and low-volume providers...
October 18, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29035980/incidence-of-symptomatic-pulmonary-embolus-and-deep-vein-thrombosis-after-knee-arthroscopy-in-the-pediatric-and-adolescent-population
#2
Brian C Lau, Jason Jagodzinski, Nirav K Pandya
OBJECTIVE: The incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE) after pediatric knee arthroscopy is unknown. The purpose of this study was to determine the incidence of venous thromboembolism (VTE) after knee arthroscopy in the pediatric and adolescent population in a high-volume center. DESIGN: Retrospective cohort study. SETTING: Tertiary care children's hospital. PATIENTS: All patients who underwent arthroscopy of the knee for a sports-related injury by 2 surgeons were reviewed...
October 10, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/29033616/nationwide-trends-of-clinical-characteristics-and-economic-burden-of-emergency-department-visits-due-to-acute-ischemic-stroke
#3
Mark Stuntz, Katsiaryna Busko, Shumaila Irshad, Taylor Paige, Veranika Razhkova, Tim Coan
We aimed to provide estimates of the volume and associated charges of acute ischemic stroke (AIS) visits in the US, as well as to assess predictors of patient disposition following an emergency department (ED) visit for AIS. Our study was conducted using the 2010-2013 data from the Nationwide Emergency Department Sample. We identified adult visits with AIS as the primary diagnosis. A generalized linear model was used to calculate mean charges per visit after adjusting for covariates. Multinomial logistic regression was used to assess predictors of patient disposition following an ED visit for AIS...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29032706/quality-and-predictors-of-diabetes-care-among-patients-with-schizophrenia-a-danish-nationwide-study
#4
Mette Jørgensen, Jan Mainz, Fabrizio Carinci, Reimar W Thomsen, Søren Paaske Johnsen
OBJECTIVE: Patients with schizophrenia have a high prevalence of diabetes, but data on diabetes care quality for these patients are limited. This nationwide study compared the quality of diabetes care among individuals with and without schizophrenia and identified predictors of care quality. METHODS: In a population-based cohort study, 83,813 individuals with diabetes seen at hospital outpatient clinics between 2005 and 2013, including 669 with comorbid schizophrenia, were identified from Danish registries...
October 16, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29030318/the-association-between-mortality-and-distance-to-treatment-facility-in-patients-with-muscle-invasive-bladder-cancer
#5
Stephen Ryan, Emily C Serrell, Patrick Karabon, Gregory Mills, Moritz Hansen, Matthew Hayn, Mani Menon, Quoc-Dien Trinh, Firas Abdollah, Jesse D Sammon
PURPOSE: Regionalization of bladder cancer treatment is suggested to improve quality of care. As an unintended consequence, some patients travel farther for care with unknown implications on outcomes. We characterize the relationship between distance and overall mortality in patients with invasive bladder cancer and those who undergo radical cystectomy. METHODS: We performed a retrospective cohort study using the National Cancer Database (2004-2012) to identify patients with muscle invasive bladder cancer (cT2a-T4 N0 M0); a sub-group of radical cystectomy patients was extracted...
October 10, 2017: Journal of Urology
https://www.readbyqxmd.com/read/29029759/patient-centered-research-priorities-in-ovarian-cancer-a-systematic-review-of-potential-determinants-of-guideline-care
#6
REVIEW
Rachel A Pozzar, Donna L Berry
OBJECTIVE: To (a) determine what is known about the individual and contextual factors that may influence whether a woman with ovarian cancer receives guideline care, and (b) identify patient-centered research priorities in ovarian cancer. METHODS: A systematic review of the PubMed, MEDLINE, CINAHL Complete, and PsycInfo online databases. Eligible articles were published in English, described original research, and either (a) identified factors associated with the receipt of guideline care for ovarian cancer, or (b) described treatment decision making by women with ovarian cancer...
October 10, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/29029102/nucleos-t-ide-analogue-treatment-for-adult-patients-with-hbeag-positive-chronic-infection-with-genotype-c-hepatitis-b-virus-a-nationwide-real-life-study
#7
Young Chang, Won Hyeok Choe, Dong Hyun Sinn, Jeong-Hoon Lee, Sang Hoon Ahn, Hyewon Lee, Jae-Jun Shim, Dae Won Jun, Soo Young Park, Joon Yeul Nam, Eun Ju Cho, Su Jong Yu, Dong Ho Lee, Jeong Min Lee, Yoon Jun Kim, So Young Kwon, Seung Woon Paik, Jung-Hwan Yoon
Background/Aim: Antiviral treatment for patients in HBeAg-positive chronic hepatitis B virus (HBV) infection is still controversial. We assessed whether antiviral treatment reduces liver disease progression in those patients. Methods: This study included consecutive patients that tested positive for HBeAg with an HBV DNA >20,000 IU/mL, ALT <40 IU/L and without evidence of cirrhosis in eight large-volume hospitals in Korea. The primary endpoint was the development of hepatocellular carcinoma (HCC) and the secondary endpoint was the development of cirrhosis...
September 23, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29025397/a-qualitative-study-of-patient-education-needs-for-hip-and-knee-replacement
#8
Deborah Kennedy, Amy Wainwright, Lucy Pereira, Susan Robarts, Patricia Dickson, Jennifer Christian, Fiona Webster
BACKGROUND: Quality health information is key to patient engagement, self-management and an enhanced healthcare experience. There is strong evidence to support involving patients and their families in the development and evaluation of health-related educational material. These factors were the impetus for our high volume joint replacement centre to undertake a qualitative study to elicit patient experiences to inform the development of effective strategies and education along the care continuum for hip and knee replacement...
October 12, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29025099/dutch-surgeons-views-on-the-volume-outcome-mechanism-in-surgery-a-qualitative-interview-study
#9
R Mesman, M J Faber, G P Westert, H J J M Berden
Objective: To contribute to a better understanding of volume-outcome relationships in surgery by exploring Dutch surgeons' views on the underlying mechanism. Design: A qualitative study based on face-to-face semi structured interviews and an inductive content analysis approach. Setting: Interviews were conducted in eight hospitals in the Netherlands (2 university, 4 teaching and 2 general). Participants: Twenty surgeons (gastrointestinal, vascular and trauma)...
August 9, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29024364/healthcare-utilization-after-liver-transplantation-is-highly-variable-both-among-centers-and-recipients
#10
T Bittermann, R A Hubbard, M Serper, J D Lewis, S F Hohmann, L B VanWagner, D S Goldberg
The relationship between healthcare utilization before and after liver transplantation (LT) and its association with center characteristics is incompletely understood. This was a retrospective cohort study of 34,402 adult LTs between 2002-2013 using Vizient inpatient claims data linked to the United Network for Organ Sharing database. Multivariable mixed-effects linear regression models evaluated the association between hospitalization 90 days pre-LT and the number of days alive and out of the hospital (DAOH) 1 year post-LT...
October 11, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29023379/effect-of-early-pelvic-binder-use-in-the-emergency-management-of-suspected-pelvic-trauma-a-retrospective-cohort-study
#11
Sheng-Der Hsu, Cheng-Jueng Chen, Yu-Ching Chou, Sheng-Hao Wang, De-Chuan Chan
BACKGROUND: We aimed to evaluate the effect of early pelvic binder use in the emergency management of suspected pelvic trauma, compared with the conventional stepwise approach. METHODS: We enrolled trauma patients with initial stabilization using a pelvic binder when suspecting pelvic injury. The inclusion criteria were traumatic injury requiring a trauma team and at least one of the following: a loss of consciousness or a Glasgow coma score (GCS) of <13; systolic blood pressure of <90 mmHg; falling from ≥6 m; injury to multiple vital organs; and suspected pelvic injury...
October 12, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29022157/radiosurgery-in-trochlear-and-abducens-nerve-schwannomas-case-series-and-systematic-review
#12
Iulia Peciu-Florianu, Constantin Tuleasca, Jean-Nicolas Comps, Luis Schiappacasse, Michele Zeverino, Roy Thomas Daniel, Marc Levivier
INTRODUCTION: Schwannomas involving the occulomotor cranial nerves  (CNs; III, IV and VI), can be disabling, due to the associated diplopia and decreased quality of life and are extremely rare. We evaluated the role of Gamma Knife surgery (GKS) in these cases. METHODS: Five patients with CN IV and VI schwannomas (three and two, respectively) were treated in Lausanne University Hospital between 2010 and 2015. Four benefitted from upfront GKS and one from a combined approach (planned subtotal resection followed by GKS), due to a large preoperative tumour volume (size, 3 × 2 × 2...
October 11, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29021897/patient-outcome-of-emergency-laparotomy-improved-with-increasing-number-of-surgeons-on-call-in-a-university-hospital-audit-loop
#13
Anwar Hussain, Fahad Mahmood, Chui Teng, Sadaf Jafferbhoy, David Luke, Achilleas Tsiamis
AIM: Emergency laparotomy is a commonly performed high-mortality surgical procedure. The National Emergency Laparotomy Network (NELA) published an average mortality rate of 11.1% and a median length of stay equivalent to 16.3 days in patients undergoing emergency laparotomy. This study presents a completed audit loop after implementing the change of increasing the number of on-call surgeons in the general surgery rota of a university hospital. The aim of this study was to evaluate the outcomes of emergency laparotomy in a single UK tertiary centre after addition of one more consultant in the daily on-call rota...
November 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29020984/fully-digital-data-processing-during-cardiovascular-implantable-electronic-device-follow-up-in-a-high-volume-tertiary-center
#14
Ingo Staudacher, Asha Roy Nalpathamkalam, Lorenz Uhlmann, Claudius Illg, Sebastian Seehausen, Mohammadreza Akhavanpoor, Anke Buchauer, Nicolas Geis, Patrick Lugenbiel, Patrick A Schweizer, Panagiotis Xynogalos, Maura M Zylla, Eberhard Scholz, Edgar Zitron, Hugo A Katus, Dierk Thomas
BACKGROUND: Increasing numbers of patients with cardiovascular implantable electronic devices (CIEDs) and limited follow-up capacities highlight unmet challenges in clinical electrophysiology. Integrated software (MediConnect(®)) enabling fully digital processing of device interrogation data has been commercially developed to facilitate follow-up visits. We sought to assess feasibility of fully digital data processing (FDDP) during ambulatory device follow-up in a high-volume tertiary hospital to provide guidance for future users of FDDP software...
October 11, 2017: European Journal of Medical Research
https://www.readbyqxmd.com/read/29017315/thyroid-cytology-the-japanese-system-and-experience-at-yamashita-thyroid-hospital
#15
Shinya Satoh, Hiroyuki Yamashita, Kennichi Kakudo
In Japan, fine needle aspiration (FNA) cytology is the most important diagnostic modalities for triaging patients with thyroid nodules. A clinician (endocrinologist, endocrine surgeon, or head and neck surgeon) generally performs FNA cytology at the outpatient clinic, and ultrasound (US)-guided FNA is widespread because US is extremely common and most clinicians are familiar with it. Although almost all FNA thyroid samples are examined by certified cytopathologists and pathologists, some clinicians assess cytological specimens themselves...
October 11, 2017: Journal of Pathology and Translational Medicine
https://www.readbyqxmd.com/read/29016751/cardiac-effects-of-sglt2-inhibitors-the-sodium-hypothesis
#16
Edoardo Bertero, Leticia Prates Roma, Pietro Ameri, Christoph Maack
The effects of intense glycaemic control on macrovascular complications in patients with type 2 diabetes are incompletely resolved, and many glucose-lowering medications negatively affect cardiovascular outcomes. Recently, the EMPA-REG OUTCOME trial revealed that empagliflozin, an inhibitor of the sodium-glucose cotransporter 2 (SGLT2), substantially reduced the risk of hospitalization for heart failure, death from cardiovascular causes, and all-cause mortality in patients with type 2 diabetes mellitus at high cardiovascular risk...
August 4, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/29016436/trends-and-disparities-in-cervical-spine-fusion-procedures-utilization-in-the-new-york-state
#17
Rui Feng, Mark Finkelstein, Khawaja Bilal, Eric K Oermann, Michael Palese, John Caridi
STUDY DESIGN: A retrospective review of the Statewide Planning and Research Cooperative System database of the New York State. OBJECTIVE: This study examined the rate of increase of cervical spine fusion procedures at low-, medium-, and high-volume hospitals, and analyzed racial and socioeconomic characteristics of the patient population treated at these three volume categories. SUMMARY OF BACKGROUND DATA: There has been a steady increase in spinal fusion procedures performed each year in the US, especially cervical and lumbar fusion...
October 9, 2017: Spine
https://www.readbyqxmd.com/read/28992161/the-role-of-patient-perception-of-crowding-in-the-determination-of-real-time-patient-satisfaction-at-emergency-department
#18
Hao Wang, Jeffrey A Kline, Bradford E Jackson, Richard D Robinson, Matthew Sullivan, Marcus Holmes, Katherine A Watson, Chad D Cowden, Jessica Laureano Phillips, Chet D Schrader, JoAnna Leuck, Nestor R Zenarosa
Objective: To evaluate the associations between real-time overall patient satisfaction and Emergency Department (ED) crowding as determined by patient percepton and crowding estimation tool score in a high-volume ED. Design: A prospective observational study. Setting: A tertiary acute hospital ED and a Level 1 trauma center. Participants: ED patients. Intervention(s): Crowding status was measured by two crowding tools [National Emergency Department Overcrowding Scale (NEDOCS) and Severely overcrowded-Overcrowded-Not overcrowded Estimation Tool (SONET)] and patient perception of crowding surveys administered at discharge...
October 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28989795/a-comparison-of-multiple-sclerosis-disease-activity-after-discontinuation-of-fingolimod-and-placebo
#19
Patrick Vermersch, Ernst-Wilhelm Radue, Norman Putzki, Shannon Ritter, Martin Merschhemke, Mark S Freedman
BACKGROUND: Cases of higher-than-expected disease activity have been reported following fingolimod discontinuation. OBJECTIVE: The objective of this paper is to assess the risk of substantially higher-than-expected disease activity post-study drug discontinuation (SDD) at the individual patient level using data from the Phase III, placebo-controlled FREEDOMS and FREEDOMS II trials. METHODS: Baseline gadolinium-enhancing T1-lesion volumes were used to statistically model the expected level of MRI disease activity post-SDD...
July 2017: Multiple Sclerosis Journal—Experimental, Translational and Clinical
https://www.readbyqxmd.com/read/28988469/treatment-survival-and-costs-of-oropharyngeal-cancer-care-in-the-elderly
#20
Christine G Gourin, Carole Fakhry, Harry Quon, Hyunseok Kang, Ana P Kiess, Robert J Herbert, David W Eisele, Kevin D Frick
OBJECTIVES/HYPOTHESIS: To examine associations between treatment, survival, and costs in elderly patients with oropharyngeal squamous cell cancer (OPSCC). STUDY DESIGN: Retrospective cross-sectional analysis of Surveillance, Epidemiology, and End Results-Medicare data. METHODS: We evaluated 666 patients diagnosed with OPSCC from 2004 to 2007 using cross-tabulations, multivariate logistic and generalized linear regression modeling, and survival analysis...
October 8, 2017: Laryngoscope
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