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High Volume Hospitals

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https://www.readbyqxmd.com/read/28534080/pathologic-complete-response-rates-after-neoadjuvant-treatment-in-rectal-cancer-an-analysis-of-the-national-cancer-database
#1
Patrick D Lorimer, Benjamin M Motz, Russell C Kirks, Danielle M Boselli, Kendall K Walsh, Roshan S Prabhu, Joshua S Hill, Jonathan C Salo
BACKGROUND: Pathologic complete response (pCR) of rectal cancer following neoadjuvant therapy is associated with decreased local recurrence and increased overall survival. This study utilizes a national dataset to identify predictors of pCR in patients with rectal cancer. METHODS: The National Cancer Database was queried for patients with nonmetastatic rectal cancer (2004-2014) who underwent neoadjuvant therapy and surgical resection. Unadjusted associations were assessed using rank-sum tests and χ (2) tests where appropriate...
May 22, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28533536/a-systemic-review-and-an-updated-meta-analysis-minimally-invasive-vs-open-pancreaticoduodenectomy
#2
Zhanwei Zhao, Zifang Yin, Zhenning Hang, Gang Ji, Quanxin Feng, Qingchuan Zhao
The feasible of minimally invasive pancreaticoduodenectomy (MIPD) remains controversial when compared with open pancreaticoduodenectomy (OPD). We conducted a systemic review and meta-analysis to summarise the available evidence to compare MIPD vs OPD. We systemically searched PubMed, EMBASE and Web of Science for studies published through February 2016. The primary endpoint was postoperative pancreatic fistula (POPF, grade B/C). A total of 27 studies involving 14,231 patients (2,377 MIPD and 11,854 OPD) were included...
May 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28532909/volume-outcome-relationship-after-1-and-2-level-anterior-cervical-discectomy-and-fusion
#3
Rafael De la Garza Ramos, Jonathan Nakhla, Rani Nasser, Ajit Jada, Niketh Bhashyam, Merritt D Kinon, Reza Yassari
OBJECTIVE: To investigate the impact of surgeon volume on inpatient morbidity after 1- and 2-level anterior cervical discectomy and fusion (ACDF). METHODS: Data from the Nationwide Inpatient Sample from 2009 were extracted. All adult patients who underwent an elective 1- or 2-level ACDF for degenerative cervical spine disease were identified. Surgeon volume was analyzed as a continuous and categorical variable (very-low (<12 procedures per year), low (12 - 23), medium (24 - 35), high (36 - 47), and very-high volume (48 or more))...
May 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28529992/minimally-invasive-surgery-for-gastric-cancer-in-usa-current-status-and-future-perspectives
#4
REVIEW
Ashley Russo, Vivian E Strong
The World Health Organization (WHO) has declared gastric carcinoma a global health concern and gastric cancer remains the third leading cause of cancer deaths worldwide. With the rising incidence of gastric cancer, a body of both retrospective and randomized data has emerged since the early 1990's evaluating the role of minimally invasive platforms in the management of gastric cancer. While Eastern studies have shown that the laparoscopic approach is safe and feasible for advanced gastric cancer in Eastern patients, it is not clear whether this is true for patients in the West...
2017: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28523862/transatlantic-medical-consultation-and-second-opinion-in-pediatric-cardiology-has-benefit-past-patient-care-a-case-study-in-videoconferencing
#5
Lubica Kovacikova, Martin Zahorec, Peter Skrak, Brian D Hanna, R Lee Vogel
BACKGROUND: Telemedicine is a rapidly evolving form of modern information and communication technology used to deliver clinical services and educational activities. OBJECTIVE: The aim of this article is to report and analyze our experience with transatlantic consultation via videoconferencing in pediatric cardiology. METHODS: In February, 2013, videoconferencing project was launched between a medium-volume pediatric cardiac center in Bratislava, Slovakia and subspecialty experts from a high-volume pediatric cardiac program at The Children's Hospital of Philadelphia (CHOP), USA...
May 19, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28523161/the-safety-profile-of-preoperative-administration-of-heparin-for-thromboprophylaxis-in-chinese-patients-intended-for-thoracoscopic-major-thoracic-surgery-a-pilot-randomized-controlled-study
#6
Han-Yu Deng, Chang-Lin Shi, Gang Li, Jun Luo, Zhi-Qiang Wang, Yi-Dan Lin, Lun-Xu Liu, Qing-Hua Zhou
BACKGROUND: Patients undergoing major thoracic surgery especially for cancers are at a high risk of perioperative thromboembolism. Current guidelines recommended either heparin sodium (unfractionated heparin) or low-molecular-weight heparin (LMWH) for those patients at high risk of deep vein thrombosis (DVT). However, the rational timing of starting heparin has not yet been well established, because DVT can be caused by not only surgery but also comorbidities as well as prolonged hospital stay, and thoracic surgeons always concerned about heparin-related increased risk of intra- or post-operative bleeding...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28520542/hybrid-palliation-for-interrupted-aortic-arch-with-small-aortic-valve
#7
Yoshimasa Uno, Ayumu Masuoka, Kentarou Hotoda, Toshiyuki Katogi, Takaaki Suzuki
OBJECTIVES: Open heart surgery for interrupted aortic arch in the neonatal period is still a high-risk procedure related in part to patient factors such as low birth weight, other morphologic anomalies, and, especially, small aortic valve size. Recently, we performed hybrid palliation with bilateral pulmonary artery banding and ductal stenting as the first-stage palliation for such cases. In this study, the outcomes of this procedure were examined. METHODS: Six cases of interrupted aortic arch with a small aortic valve underwent the hybrid procedure in the neonatal period in our institute from 2010 to 2015 (mean age: 6...
May 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28517236/effect-of-centralization-on-long-term-survival-after-resection-of-pancreatic-ductal-adenocarcinoma
#8
R Ahola, A Siiki, K Vasama, M Vornanen, J Sand, J Laukkarinen
BACKGROUND: Centralization of pancreatic surgery has resulted in improved short-term outcomes in a number of healthcare systems. The aim of this study was to see whether hospital volume influenced long-term prognosis, use of adjuvant therapy or histopathological evaluation of patients undergoing surgical resection for pancreatic ductal adenocarcinoma (PDAC). METHODS: Patients undergoing surgical resection of PDAC in Finland between 2002 and 2008 were identified from national registers...
May 18, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28514469/association-of-very-low-volume-practice-with-vascular-surgery-outcomes-in-new-york
#9
Jialin Mao, Philip Goodney, Jack Cronenwett, Art Sedrakyan
Importance: Little research has focused on very low-volume surgery, especially in the context of decreasing vascular surgery volume with the adoption of endovascular procedures. Objective: To investigate the existence and outcomes of open abdominal aortic aneurysm repair (OAR) and carotid endarterectomy (CEA) performed by very low-volume surgeons in New York. Design, Settings, and Participants: This cohort study examined inpatient data of patients undergoing elective OAR or CEA from 2000 to 2014 from all New York hospitals...
May 17, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28513197/uptake-of-telehealth-implementation-for-copd-patients-in-a-high-poverty-inner-city-environment-a-survey
#10
Catherine L Granger, Rachel Wijayarathna, Eui-Sik Suh, Gill Arbane, Linda Denehy, Patrick Murphy, Nicholas Hart
This study aimed to investigate computer and internet access and education attained in patients with chronic obstructive pulmonary disease (COPD) as potential barriers to implementation of telemedicine. We prospectively assessed 98 patients admitted with an acute exacerbation of COPD (mean age: 70.5 ± 9.3 years; force expired volume in the first second: 0.75 ± 0.39 L; 59% male) recording educational level attained and home computer and internet access. Hospital readmission surveillance occurred up to 2.7 (2...
January 1, 2017: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/28512089/physician-age-and-outcomes-in-elderly-patients-in-hospital-in-the-us-observational-study
#11
Yusuke Tsugawa, Joseph P Newhouse, Alan M Zaslavsky, Daniel M Blumenthal, Anupam B Jena
Objectives To investigate whether outcomes of patients who were admitted to hospital differ between those treated by younger and older physicians.Design Observational study.Setting US acute care hospitals.Participants 20% random sample of Medicare fee-for-service beneficiaries aged ≥65 admitted to hospital with a medical condition in 2011-14 and treated by hospitalist physicians to whom they were assigned based on scheduled work shifts. To assess the generalizability of findings, analyses also included patients treated by general internists including both hospitalists and non-hospitalists...
May 16, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28511965/relationship-between-hospital-volume-and-outcomes-in-patients-with-traumatic-brain-injury-a-retrospective-observational-study-using-a-national-inpatient-database-in-japan
#12
Tomoki Wada, Hideo Yasunaga, Kent Doi, Hiroki Matsui, Kiyohide Fushimi, Yoichi Kitsuta, Susumu Nakajima
BACKGROUND: The relationship between hospital volume and outcome after traumatic brain injury (TBI) is not completely understood in a real clinical setting. We investigated whether patients admitted with TBI achieved better outcomes in high-volume hospitals than in low-volume hospitals using a national inpatient database in Japan. METHODS: This retrospective cohort study used the Diagnosis Combination Procedure database in Japan. We included patients with TBI admitted to hospitals with a Japan Coma Scale (JCS) score ≥2 between April 1, 2013 and March 31, 2014...
May 3, 2017: Injury
https://www.readbyqxmd.com/read/28511884/the-impact-of-quality-variations-on-patients-undergoing-surgery-for-renal-cell-carcinoma-a-national-cancer-database-study
#13
Keith A Lawson, Olli Saarela, Robert Abouassaly, Simon P Kim, Rodney H Breau, Antonio Finelli
BACKGROUND: Despite efforts to define metrics assessing hospital-level quality for renal cell carcinoma (RCC) surgical care there remains a paucity of real-world data validating their ability to benchmark performance. Consequently, whether poor performance on hospital-level quality indicators is associated with inferior patient outcomes remains unknown. OBJECTIVES: To determine hospital-level variations in RCC surgical quality after adjusting for differences in patient- and tumor-specific factors...
May 13, 2017: European Urology
https://www.readbyqxmd.com/read/28508236/an-exploratory-analysis-of-the-geographical-distribution-of-trauma-incidents-in-shenzhen-china
#14
Gui Xi Zhang, Joe King Man Fan, Fion Siu Yin Chan, Gilberto Ka Kit Leung, Chung Mao Lo, Yi Min Yu, Hong Zhang, Susan I Brundage, Jan O Jansen
BACKGROUND: The city of Shenzhen, China, is planning to establish a trauma system. At present, there are few data on the geographical distribution of incidents, which is key to deciding on the location of trauma centres. The aim of this study was to perform a geographical analysis in order to inform the development of a trauma system in Shenzhen. METHODS: Retrospective analysis of trauma incidents attended by Shenzhen Emergency Medical Services (EMS) in 2014. Data were obtained from Shenzhen EMS...
May 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28508087/the-vitamin-d-for-enhancing-the-immune-system-in-cystic-fibrosis-disc-trial-rationale-and-design-of-a-multi-center-double-blind-placebo-controlled-trial-of-high-dose-bolus-administration-of-vitamin-d3-during-acute-pulmonary-exacerbation-of-cystic-fibrosis
#15
Vin Tangpricha, Ellen M Smith, Jose Binongo, Suzanne E Judd, Thomas R Ziegler, Seth Walker, Rabindra Tirouvanziam, Susu M Zughaier, Moon Jeong Lee, Supavit Chesdachai, Wendy A Hermes, James F Chmiel, Amit Gaggar, Ruth E Grossmann, Patricia M Joseph, Jessica A Alvarez
Vitamin D deficiency is highly prevalent in children and adults with cystic fibrosis (CF). Recent studies have found an association between vitamin D status and risk of pulmonary exacerbations in children and adults with CF. The ongoing Vitamin D for enhancing the Immune System in Cystic fibrosis (DISC) study is a multi-center, double-blind, randomized, placebo-controlled trial that will test the hypothesis of whether high dose vitamin D given as a single oral bolus of 250,000 IU to adults with CF during a pulmonary exacerbation followed by a maintenance dose of vitamin D will improve time to next pulmonary exacerbation and re-hospitalization, improve survival and lung function compared to placebo and reduce the rates of pulmonary exacerbation,...
June 2017: Contemporary Clinical Trials Communications
https://www.readbyqxmd.com/read/28505401/the-influence-of-a-composite-hospital-volume-on-outcomes-for-gastric-cancer-surgery-a-dutch-population-based-study
#16
Linde A D Busweiler, Johan L Dikken, Daniel Henneman, Mark I van Berge Henegouwen, Vincent K Y Ho, Rob A E M Tollenaar, Michel W J M Wouters, Johanna W van Sandick
BACKGROUND: Volume-outcome associations for complex surgical procedures have motivated centralization of care worldwide. The aim of this study was to investigate the association between overall hospital experience with complex upper gastrointestinal (GI) cancer resections and outcomes after gastric cancer surgery. METHODS: Data on all patients (n = 4837) who underwent a resection for non metastatic invasive gastric cancer between 2005 and 2014 were obtained from the Netherlands Cancer Registry (NCR)...
May 15, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28504235/sweden-coronary-and-structural-heart-interventions-from-2010-to-2015
#17
Nils Witt, Andreas Rück, Stefan K James, Sasha Koul, Bo Lagerqvist
Sparsely populated and with wide non-urbanised areas, Sweden faces specific challenges in providing publicly financed, high-quality and equal healthcare to all parts of the country. As a result, a decentralised organisation for acute coronary care has been developed with coronary care units and catheterisation laboratories in several small- and medium-sized city areas. In contrast, highly specialised non-emergent interventional procedures are centralised to a few high-volume centres, mainly located at university hospitals in large city areas...
May 15, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28504224/denmark-coronary-and-structural-heart-interventions-from-2010-to-2015
#18
Hans-Henrik Tilsted, Ole Ahlehoff, Christian J Terkelsen, Frants Pedersen, Cengiz Özcan, Troels H Jørgensen, Jens E Nielsen-Kudsk, Jan Ravkilde, Henrik Nissen, Sune A Pedersen, Ole Havndrup, Jens F Lassen
Interventional cardiology in Denmark has been carried out since the mid 1980s. Interventional cardiology is only performed at a few high-volume centres. Healthcare coverage is universal and is essentially free of charge. Hospitals are mostly publicly owned and financed by fixed budgets and, in part, an activity-based funding system. Approximately 30,000 coronary angiographies (CAG), 10,000 percutaneous coronary interventions (PCIs) of which approximately 25% are primary PCIs, and 500 transcatheter aortic valve implantations (TAVIs) are carried out each year...
May 15, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28502029/a-longitudinal-analysis-of-short-term-costs-and-outcomes-in-a-regionalized-center-of-excellence-bariatric-care-system
#19
Aristithes G Doumouras, Fady Saleh, Sama Anvari, Scott Gmora, Mehran Anvari, Dennis Hong
BACKGROUND: Evaluating how morbidity and costs evolve for new bariatric centers is vital to understanding the expected length of time required to reach optimal outcomes and cost efficiencies. Accordingly, the objective of this study was to evaluate how morbidity and costs changed longitudinally during the first 5 years of a regionalized center of excellence system. METHODS: This was a longitudinal analysis of the first 5 years of a bariatric center of excellence system...
May 13, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28499130/extracorporeal-membrane-oxygenation-ecmo-as-a-treatment-strategy-for-severe-acute-respiratory-distress-syndrome-ards-in-the-low-tidal-volume-era-a-systematic-review
#20
REVIEW
Bourke W Tillmann, Michelle L Klingel, Alla E Iansavichene, Ian M Ball, A Dave Nagpal
OBJECTIVE: To evaluate the hospital survival in patients with severe ARDS managed with ECMO and low tidal volume ventilation as compared to patients managed with low tidal volume ventilation alone. METHODS: Electronic databases were searched for studies of at least 10 adult patients with severe ARDS comparing the use of ECMO with low tidal volume ventilation to mechanical ventilation with a low tidal volume alone. Only studies reporting hospital or ICU survival were included...
April 27, 2017: Journal of Critical Care
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