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https://www.readbyqxmd.com/read/28807634/-severity-assessment-strategies-based-on-administrative-data-using-stroke-as-an-example
#1
Ingrid Schubert, Antje Hammer, Ingrid Köster
BACKGROUND AND OBJECTIVES: Information on disease severity is relevant for many studies with claims data in health service research, but only limited information is available in routine data. Stroke serves as an example, to analyse whether the combination of different information in claims data can provide insight into the severity of a disease. METHOD: As a first step, a literature search was conducted. Strategies to assess the severity of a disease by means of routine data were examined with regards and applicability to German sickness fund data...
August 11, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28760801/polyethylene-glycol-intestinal-lavage-in-addition-to-usual-antibiotic-treatment-for-severe-clostridium-difficile-colitis-a-randomised-controlled-pilot-study
#2
Greig McCreery, Philip M Jones, Biniam Kidane, Vanessa DeMelo, Tina Mele
INTRODUCTION: Clostridium difficile infections (CDI) are common, costly and potentially life threatening. Most CDI will respond to antibiotic therapy, but 3%-10% of all patients with CDI will progress to a severe, life-threatening course. Complete removal of the large bowel is indicated for severe CDI. However, the 30-day mortality following surgical intervention for severe CDI ranges from 20% to 70%. A less invasive approach using surgical faecal diversion and direct colonic lavage with polyethylene glycol (PEG) and vancomycin has demonstrated a relative mortality reduction of approximately 50%...
July 31, 2017: BMJ Open
https://www.readbyqxmd.com/read/28729942/problems-related-to-levodopa-carbidopa-intestinal-gel-treatment-in-advanced-parkinson-s-disease
#3
Marianne Udd, Jukka Lyytinen, Johanna Eerola-Rautio, Anu Kenttämies, Outi Lindström, Leena Kylänpää, Eero Pekkonen
BACKGROUND: Continuous levodopa-carbidopa intestinal gel (LCIG) diminishes daily "off" time and dyskinesia in patients with advanced Parkinson's disease (PD). Complications are common with percutaneous endoscopic gastrostomy with a jejunal extension tube (PEG-J). AIM OF THE STUDY: To report the clinical outcome of LCIG in patients with advanced PD in the years 2006-2014 at Helsinki University Hospital. PATIENTS AND METHODS: Levodopa-carbidopa intestinal gel treatment started following PEG-J placement in patients with advanced PD after successful in-hospital LCIG trial with a nasojejunal tube...
July 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28728345/safety-of-percutaneous-endoscopic-gastrostomy-tubes-in-centenarian-patients
#4
Zain A Sobani, Kevin Tin, Steven Guttmann, Anna A Abbasi, Ira Mayer, Yuriy Tsirlin
Background/Aims: Percutaneous endoscopic gastrostomy (PEG) is a relatively safe procedure; however, no study has evaluated the safety of PEG tube placement in patients over the age of 100 years. Methods: We conducted a retrospective review of patient records for patients who underwent PEG tube placement. Thirty patients aged 100 years and older were identified and a random sample of 275 patients was selected for comparison. Results: The mean age of the patients was 80...
July 21, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28725304/high-c-reactive-protein-and-low-albumin-levels-predict-high-30-day-mortality-in-patients-undergoing-percutaneous-endoscopic-gastrotomy
#5
Omer Karasahin, Pinar Tosun Tasar, Ozge Timur, Dogan Nasir Binici, Tugba Kiper Yilmaz, Adem Aslan, Sevnaz Sahin
BACKGROUND: Percutaneous endoscopic gastrotomy (PEG) enables long-term enteral feeding. The aim of this study was to identify biomarkers that may guide the decision of whether to perform the elective procedure of PEG. METHODS: The medical records of all patients who underwent PEG in our hospital from 2010 to 2016 were screened retrospectively. Patients with mortality within a 30-day follow-up period and those without were compared using the Chi-square test, and continuous variables were compared with the Kruskal-Wallis and Mann-Whitney U tests...
June 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28660520/comparison-of-complications-following-laparoscopic-and-endoscopic-gastrostomy-placements
#6
Sara L Zettervall, Jeremy L Holzmacher, Michal Radomski, Matthew Skancke, Justin Shafa, Richard Amdur, Babak Sarani, Khashayar Vaziri
INTRODUCTION: Percutaneous endoscopic gastrostomy (PEG) and laparoscopic gastrostomy (LG) placements provide enteral access to patients unable to tolerate oral feeds. Limited data comparing PEG and LG outcomes is available in adults. This study compares complications between PEG and LG placements. MATERIALS AND METHODS: A retrospective chart review was completed for patients undergoing PEG or LG placement at a single academic center between 2007 and 2014. Patient demographics, comorbidities, and Charlson Comorbidity Index (CCI) were compared...
June 28, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28507748/comparison-of-the-pull-and-introducer-percutaneous-endoscopic-gastrostomy-techniques-in-patients-with-head-and-neck-cancer
#7
Felipe A Retes, Fabio S Kawaguti, Marcelo S de Lima, Bruno da Costa Martins, Ricardo S Uemura, Gustavo A de Paulo, Caterina Mp Pennacchi, Carla Gusmon, Adriana Vs Ribeiro, Elisa R Baba, Sebastian N Geiger, Mauricio P Sorbello, Marco A Kulcsar, Ulysses Ribeiro, Fauze Maluf-Filho
BACKGROUND AND STUDY AIMS: Percutaneous endoscopic gastrostomy (PEG) in head and neck cancer (HNC) patients is associated with higher complication and mortality rates when compared to a general patient population. The pull technique is still the preferred technique worldwide but it has some limitations. The aim of this study is to compare the pull and introducer PEG techniques in patients with HNC. PATIENTS AND METHODS: This study is based on a retrospective analysis of a prospectively collected database of 309 patients with HNC who underwent PEG in the Cancer Institute of São Paulo...
April 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28449220/survival-functional-status-and-eating-ability-after-percutaneous-endoscopic-gastrostomy-tube-placement-for-acute-stroke
#8
Karl Meisel, Robert M Arnold, Irena Stijacic Cenzer, John Boscardin, Alexander K Smith
OBJECTIVES: To determine the long-term survival and independence of individuals with stroke and percutaneous endoscopic gastrostomy (PEG) tube placement. DESIGN: Retrospective cohort study. SETTING: A longitudinal nationally representative community-based sample of older adults. PARTICIPANTS: Individuals with stroke who had a PEG tube placed (N = 174, mean age 79, 51% female, 29% African American). MEASUREMENTS: Functional status before incident stroke was determined based on data from the Health and Retirement Study (HRS), a national longitudinal survey of community-dwelling older adults, from 1993 to 2012...
April 27, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28301921/health-care-utilization-and-complications-of-endoscopic-esophageal-dilation-in-a-national-population
#9
Abhinav Goyal, Kshitij Chatterjee, Sujani Yadlapati, Shailender Singh
BACKGROUND/AIMS: Esophageal stricture is usually managed with outpatient endoscopic dilation. However, patients with food impaction or failure to thrive undergo inpatient dilation. Esophageal perforation is the most feared complication, and its risk in inpatient setting is unknown. METHODS: We used National Inpatient Sample (NIS) database for 2007-2013. International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) codes were used to identify patients with esophageal strictures...
July 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28282009/low-abdominal-wall-thickness-may-predict-percutaneous-endoscopic-gastrostomy-complications
#10
Melissa K James, Vanessa P Ho, Simon P Tiu, Richard J Tom, Taylor R Klein, Gloria M Melnic, Sebastian D Schubl
Although percutaneous endoscopic gastrostomy (PEG) tube placement is a common and safe procedure to provide enteral feeding, some patients develop complications. The aim of this study was to identify risk factors for the development of post-PEG complications. We hypothesized that patients with low albumin, diabetes, higher body mass index (BMI), thicker abdominal walls, or psychomotor agitation would have more complications. A 2-year retrospective review was performed on patients who received a PEG tube at a single institution...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28255151/abdominal-wall-necrotising-fasciitis-a-rare-but-devastating-complication-of-the-percutaneous-endoscopic-gastrostomy-procedure
#11
M R Mohd Said, R Abdul Rani, R A Raja Ali, C S Ngiu
Percutaneous Endoscopic Gastrostomy (PEG) tubes were often offered to patients requiring long term enteral feeding. Even though the procedure is relatively safe, it is associated with various complications such as peritonitis or even death.1 We presented a case of a 54-year-old gentleman with underlying ischemic stroke and pus discharges from a recently inserted PEG tube. Computed Topography (CT) scan confirmed abdominal wall necrotising fasciitis complicated with hyperosmolar hyperglycaemia state (HHS) and later succumbed after 48 hours of admission...
February 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28243007/analysis-of-patients-%C3%A2-65-with-predominant-cervical-spine-fractures-issues-of-disposition-and-dysphagia
#12
Lisa M Poole, Phong Le, Rachel M Drake, Stephen D Helmer, James M Haan
BACKGROUND: Cervical spine fractures occur in 2.6% to 4.7% of trauma patients aged 65 years or older. Mortality rates in this population ranges from 19% to 24%. A few studies have specifically looked at dysphagia in elderly patients with cervical spine injury. AIMS: The aim of this study is to evaluate dysphagia, disposition, and mortality in elderly patients with cervical spine injury. SETTINGS AND DESIGN: Retrospective review at an the American College of Surgeons-verified level 1 trauma center...
January 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28228206/low-abdominal-wall-thickness-may-predict-percutaneous-endoscopic-gastrostomy-complications
#13
Melissa K James, Vanessa P Ho, Simon P Tiu, Richard J Tom, Taylor R Klein, Gloria M Melnic, Sebastian D Schubl
Although percutaneous endoscopic gastrostomy (PEG) tube placement is a common and safe procedure to provide enteral feeding, some patients develop complications. The aim of this study was to identify risk factors for the development of post-PEG complications. We hypothesized that patients with low albumin, diabetes, higher body mass index (BMI), thicker abdominal walls, or psychomotor agitation would have more complications. A 2-year retrospective review was performed on patients who received a PEG tube at a single institution...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28139230/comparison-of-operative-outcomes-between-surgical-gastrostomy-and-percutaneous-endoscopic-gastrostomy-in-infants
#14
Shin Miyata, Fanglong Dong, Olga Lebedevskiy, Hanna Park, Nam Nguyen
PURPOSE: Safety profile of different gastrostomy procedures in small children has not been well studied. This study was conducted to investigate whether complication and mortality rates differ between surgical gastrostomy (G-tube) and percutaneous endoscopic gastrostomy (PEG) in infants and neonates. METHODS: In this retrospective study utilizing the Kids' Inpatient Database, all infants who underwent either G-tube or PEG as a sole procedure were identified. Variables included age, gender, race, presence of neurological impairment, prematurity, complex chronic condition, and severity of illness/risk of mortality subclasses...
January 23, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28009454/direct-estimation-for-adaptive-treatment-length-policies-methods-and-application-to-evaluating-the-effect-of-delayed-peg-insertion
#15
Xin Lu, Brent A Johnson
Dysphagia is a primary cause of death among patients diagnosed with amyotrophic lateral sclerosis (ALS), and percutaneous endoscopic gastrostomy (PEG) is a procedure to insert a tube into the stomach to assist or replace oral feeding. It is believed that PEG is beneficial and, generally, earlier insertion is preferable to later. However, gathering clinical evidence to support these beliefs on the use and timing of PEG is challenging because controlled clinical trials are not feasible and clinical endpoints are confounded with PEG in observational data...
December 23, 2016: Biometrics
https://www.readbyqxmd.com/read/27891266/a-silent-and-chronic-complication-of-percutaneous-endoscopic-gastrostomy-tube-small-bowel-enterocutaneous-fistula
#16
Sai Wah Cheung
Percutaneous endoscopic gastrostomy (PEG) has gradually gained the popularity since its invention and become the most preferred method for gastrostomy insertion in recent years. PEG is associated with lower morbidity and mortality and has the advantages of being minimally invasive and more convenient over the conventional open gastrostomy. However, significant rates of major complication still occur. Enterocutaneous fistula is one of the key complications that can be easily neglected due to its asymptomatic nature...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27799884/thirty-day-mortality-after-percutaneous-gastrostomy-by-endoscopic-versus-radiologic-placement-a-systematic-review-and-meta-analysis
#17
Joo Hyun Lim, Seung Ho Choi, Changhyun Lee, Ji Yeon Seo, Hae Yeon Kang, Jong In Yang, Su Jin Chung, Joo Sung Kim
BACKGROUND/AIMS: A percutaneous gastrostomy can be placed either endoscopically (percutaneous endoscopic gastrostomy, PEG) or radiologically (radiologically-inserted gastrostomy, RIG). However, there is no consistent evidence of the safety and efficacy of PEG compared to RIG. Recently, 30-day mortality has become considered as the most important surrogate index for evaluating the safety and efficacy of percutaneous gastrostomy. The aim of this meta-analysis was to compare the 30-day mortality rates between PEG and RIG...
October 2016: Intestinal Research
https://www.readbyqxmd.com/read/27737522/percutaneous-endoscopic-gastrostomy-tube-insertion-in-neurodegenerative-disease-a-retrospective-study-and-literature-review
#18
Pamela Sarkar, Alice Cole, Neil J Scolding, Claire M Rice
BACKGROUND/AIMS: With the notable exceptions of dementia, stroke, and motor neuron disease, relatively little is known about the safety and utility of percutaneous endoscopic gastrostomy (PEG) tube insertion in patients with neurodegenerative disease. We aimed to determine the safety and utility of PEG feeding in the context of neurodegenerative disease and to complete a literature review in order to identify whether particular factors need to be considered to improve safety and outcome...
May 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/27678507/infant-gastrostomy-outcomes-the-cost-of-complications
#19
COMPARATIVE STUDY
Rachel M Landisch, Ryan C Colwell, John C Densmore
PURPOSE: Comparative outcomes of enhanced percutaneous endoscopic gastrostomy (PEG) and laparoscopic gastrostomy (LG) have not been elucidated in infants. We describe the outcomes and procedural episodic expenditures of PEG versus LG in this high-risk population. METHODS: One hundred eighty-three gastrostomies in children under 1year were reviewed from our institution spanning 1/2011-6/2015. Pertinent demographics and 3-month complications (mortality, gastrocolic fistula, reoperation, cellulitis, granulation, pneumonia, and tube dislodgement <6weeks) were collected...
December 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27573920/growth-and-nutrition-in-children-with-ataxia-telangiectasia
#20
Emma Stewart, Andrew P Prayle, Alison Tooke, Sara Pasalodos, Mohnish Suri, Andy Bush, Jayesh M Bhatt
BACKGROUND: Ataxia telangiectasia (A-T) is a rare multisystem disease with high early mortality from lung disease and cancer. Nutritional failure adversely impacts outcomes in many respiratory diseases. Several factors influence nutrition in children with A-T. We hypothesised that children with A-T have progressive growth failure and that early gastrostomy tube feeding (percutaneous endoscopic gastrostomy, PEG) is a favourable management option with good nutritional outcomes. METHODS: Data were collected prospectively on weight, height and body mass index (BMI) at the national paediatric A-T clinic...
December 2016: Archives of Disease in Childhood
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