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Chf readmission

Amy Richardson, Elizabeth Tolley, Jonathan Hartmann, Jasmine Reedus, Brandi Bowlin, Christopher Finch, Christopher W Sands, Timothy Self
INTRODUCTION: Approximately 1 in 5 hospitalized COPD patients are readmitted within 30 days of discharge. CHF coexists in more than 20% of patients with COPD, and is associated with early readmission for COPD. Reducing 30-day hospital readmissions for COPD is of intense current interest. METHODOLOGY: A retrospective chart review was performed to identify patients discharged with COPD exacerbation and HFrEF. The primary objective was to evaluate if discharge medication prescribing following guidelines for both COPD and HFrEF correlates with reduced 30-day readmission rates...
October 2016: Respiratory Medicine
Lior Turgeman, Jerrold H May
OBJECTIVE: A hospital readmission is defined as an admission to a hospital within a certain time frame, typically thirty days, following a previous discharge, either to the same or to a different hospital. Because most patients are not readmitted, the readmission classification problem is highly imbalanced. MATERIALS AND METHODS: We developed a hospital readmission predictive model, which enables controlling the tradeoff between reasoning transparency and predictive accuracy, by taking into account the unique characteristics of the learned database...
September 2016: Artificial Intelligence in Medicine
Palmira Bernocchi, Simonetta Scalvini, Tiziana Galli, Mara Paneroni, Doriana Baratti, Ottavia Turla, Maria Teresa La Rovere, Maurizio Volterrani, Michele Vitacca
BACKGROUND: Chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) frequently coexist, significantly reducing patients' quality of life and increasing morbidity and mortality. For either single disease, a multidisciplinary disease-management approach supported by telecommunication technologies offers the best outcome in terms of prolonged survival and reduced hospital readmissions. However, no data exist in patients with combined COPD/CHF. We planned a randomized controlled trial to investigate the feasibility and efficacy of an integrated, home-based, medical/nursing intervention plus a rehabilitation program versus conventional care in patients with coexisting COPD/CHF...
2016: Trials
Manuel Cabrera, Joseph Finkelstein
Polypharmacy in older adults results in multiple negative clinical consequences including increased risk of hospital readmissions. Precision medicine may provide tools to optimize complex medication regimens however its potential in older adults with polypharmacy is unknown. We carried out pharmacogenetic testing in an older adult with multiple chronic conditions and polypharmacy who was concerned about frequent readmissions despite receiving guideline-concordant care and being adherent to medication regimen...
2016: AMIA Summits on Translational Science Proceedings
Paskariatne Probo Dewi Yamin, Sunu Budhi Raharjo, Vebiona Kartini Prima Putri, Nani Hersunarti
BACKGROUND: Hospital length of stay (LOS) is a key determinant of heart failure hospitalization costs. Longer LOS is associated with lower quality of care measures and higher rates of readmission and mortality. Right ventricular (RV) dysfunction predicted poor outcomes in patients with stable chronic heart failure (CHF), however, its prognostic value in the acute decompensated heart failure (ADHF) patients has not been sufficiently clarified. This study investigated the prognostic value of RV dysfunction in predicting longer LOS in ADHF patients...
2016: Cardiovascular Ultrasound
Xiaohui Li, Xing Wu, Hongwei Li, Hui Chen, Yongliang Wang, Weiping Li, Xiaosong Ding, Xu Hong
BACKGROUND: Few clinical studies have assessed Rho kinase (ROCK) in patients with dia-betes mellitus (DM) and ST-segment elevation myocardial infarction (STEMI). This study aimed to determine whether ROCK activity in circulating leukocytes is increased in STEMI patients with DM and whether ROCK activity predicts the onset of cardiovascular events. METHODS: Blood samples were collected from 60 STEMI patients, divided into non-diabetes mellitus (NDM) and DM groups...
2016: Cardiology Journal
Bredy Pierre-Louis, Shareen Rodriques, Vanessa Gorospe, Achuta K Guddati, Wilbert S Aronow, Chul Ahn, Maurice Wright
INTRODUCTION: Congestive heart failure (CHF) is a common cause of hospital readmission. MATERIAL AND METHODS: A retrospective study was conducted at Harlem Hospital in New York City. Data were collected for 685 consecutive adult patients admitted for decompensated CHF from March, 2009 to December, 2012. Variables including patient demographics, comorbidities, laboratory studies, and medical therapy were compared between CHF patient admissions resulting in early CHF readmission and not resulting in early CHF readmission...
June 1, 2016: Archives of Medical Science: AMS
Andrés M Bur, Jason A Brant, Jason G Newman, Kyle M Hatten, Steven B Cannady, John P Fischer, John Y K Lee, Nithin D Adappa
OBJECTIVE: To evaluate the incidence and factors associated with 30-day readmission and to analyze risk factors for prolonged hospital length of stay following transsphenoidal pituitary surgery. STUDY DESIGN: Retrospective longitudinal claims analysis. SETTING: American College of Surgeons National Surgical Quality Improvement Program. SUBJECTS AND METHODS: The database of the American College of Surgeons National Surgical Quality Improvement Program was queried for patients who underwent transsphenoidal pituitary surgery (Current Procedural Terminology code 61548 or 62165) between 2005 and 2014...
October 2016: Otolaryngology—Head and Neck Surgery
Vanessa Yap, Rahul Mutneja, Mark Metersky
INTRODUCTION: Pneumonia remains a continuing target for performance measurement and quality improvement. The aim of this analysis was to examine 30-day all-cause readmissions after pneumonia to identify reasons for readmission and potential opportunities for improvement. METHODS: A retrospective chart review was performed on patients readmitted within 30 days after an index pneumonia hospitalization at the University of Connecticut Health Center in 2011. RESULTS: There were 54 readmissions involving 40 patients and only five (12...
March 2016: Connecticut Medicine
Costas Sideris, Mohammad Pourhomayoun, Haik Kalantarian, Majid Sarrafzadeh
Disease and symptom diagnostic codes are a valuable resource for classifying and predicting patient outcomes. In this paper, we propose a novel methodology for utilizing disease diagnostic information in a predictive machine learning framework. Our methodology relies on a novel, clustering-based feature extraction framework using disease diagnostic information. To reduce the data dimensionality, we identify disease clusters using co-occurrence statistics. We optimize the number of generated clusters in the training set and then utilize these clusters as features to predict patient severity of condition and patient readmission risk...
June 1, 2016: Computers in Biology and Medicine
Florence E Turrentine, Min-Woong Sohn, Rayford Scott Jones
BACKGROUND: Congestive heart failure (CHF) predicts surgical morbidity and mortality. However, few studies evaluate CHF's impact on noncardiac operations. Because of CHFs serious threat to health and survival, surgeons must understand risks CHF poses to patients undergoing a diverse array of operations. STUDY DESIGN: We used 2009 to 2013 American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Participant Use Files to estimate the risk of serious morbidity, reoperation, readmission, mortality, and other postoperative complications associated with preoperative diagnosis of CHF...
June 2016: Journal of the American College of Surgeons
Jo-Ann Mary Moore
Frequent exacerbations of symptoms and financial penalties for 30-day hospital readmissions of patients with congestive heart failure (CHF) have led to new disease management approaches. A nurse practitioner (NP)-led interdisciplinary program for CHF management that included home telemonitoring and early NP assessments and interventions was piloted by a home health agency. A 4-month evaluation of the efficacy of a clinical pathway for CHF patients resulted in the enrollment of 22 CHF patients in the program...
January 2016: Home Health Care Services Quarterly
Caleb Ferguson, Sally C Inglis, Phillip J Newton, Sandy Middleton, Peter S Macdonald, Patricia M Davidson
BACKGROUND: Chronic heart failure (CHF) and atrial fibrillation (AF) are complex cardiogeriatric syndromes mediated by physical, psychological and social factors. Thromboprophylaxis is an important part of avoiding adverse events in these syndromes, particularly stroke. PURPOSE: This study sought to describe the clinical characteristics of a cohort of patients admitted to hospital with CHF and concomitant AF and to document the rate and type of thromboprophylaxis...
April 1, 2016: European Journal of Cardiovascular Nursing
Seppo T Rinne, Chuan-Fen Liu, Edwin S Wong, Paul L Hebert, Paul Heidenreich, Lori A Bastian, David H Au
OBJECTIVES: In contrast to chronic heart failure (CHF), measures of quality of care for chronic obstructive pulmonary disease (COPD) are poor. Our objective was to examine differences in organizational structure available to support quality of care for patients with CHF and COPD. STUDY DESIGN: We performed 2 nationwide surveys exploring organizational structure for the management of CHF and COPD. We surveyed the chief of medicine and the chief of cardiology and pulmonary medicine at 120 Veterans Affairs facilities in the United States...
March 2016: American Journal of Managed Care
G Kamel, K Munzer, J Espiritu
BACKGROUND: Obstructive sleep apnea (OSA) has been associated with multiple cardiovascular comorbidities. Despite increased awareness of OSA and its treatments, the management of OSA in the hospital setting remains below expectations. METHODS: We retrospectively reviewed the demographics, clinical characteristics, and hospital course on 413 consecutive patients with a history of OSA on domiciliary CPAP therapy admitted to the general medical ward and analyzed the prevalence of CPAP use and its effect on length of stay (LOS), 30-day readmission rate, and time-to-readmission in our tertiary care teaching hospital...
September 2016: Sleep & Breathing, Schlaf & Atmung
Oanh Kieu Nguyen, Ethan A Halm, Anil N Makam
BACKGROUND: Hospitals that have robust financial performance may have improved publicly reported outcomes. OBJECTIVES: To assess the relationship between hospital financial performance and publicly reported outcomes of care, and to assess whether improved outcome metrics affect subsequent hospital financial performance. DESIGN: Observational cohort study. SETTING AND PATIENTS: Hospital financial data from the Office of Statewide Health Planning and Development in California in 2008 and 2012 were linked to data from the Centers for Medicare and Medicaid Services Hospital Compare website...
July 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Hae-Young Lee, Wook-Jin Chung, Hui-Kyung Jeon, Hong-Seog Seo, Dong-Ju Choi, Eun-Seok Jeon, Jae-Joong Kim, Joon Han Shin, Seok-Min Kang, Sung Cil Lim, Sang-Hong Baek
BACKGROUND/AIMS: We evaluated the association between coding region variants of adrenergic receptor genes and therapeutic effect in patients with congestive heart failure (CHF). METHODS: One hundred patients with stable CHF (left ventricular ejection fraction [LVEF] < 45%) were enrolled. Enrolled patients started 1.25 mg bisoprolol treatment once daily, then up-titrated to the maximally tolerable dose, at which they were treated for 1 year. RESULTS: Genotypic analysis was carried out, but the results were blinded to the investigators throughout the study period...
March 2016: Korean Journal of Internal Medicine
Alexandros Briasoulis, Emmanuel Androulakis, Theodoros Christophides, Dimitris Tousoulis
Chronic inflammation underlies a variety of seemingly unrelated conditions including coronary artery disease. The interest in exploring the role of inflammation in heart failure (CHF) arises from earlier observations that circulating pro-inflammatory biomarker levels are elevated in patients with both ischaemic and non-ischaemic cardiomyopathies and correlate with severity of disease and prognosis (McMurray et al. in Eur Heart J 33:1787-1847, 2012; Mosterd and Hoes in Heart 93:1137-1146, 2007; Owan et al. in New Engl J Med 355:251-259, 2006)...
March 2016: Heart Failure Reviews
Michael K Urban, Michele Mangini-Vendel, Stephen Lyman, Ting Jung Pan, Steven K Magid
BACKGROUND: The goal of elective orthopedic surgery is to return patients to their expected level of activity without an increased incidence of postoperative complications. The first step is identifying patient and/or surgical characteristics responsible for these complications. QUESTIONS/PURPOSES: This study sought to identify predictors of a step-up in medical care after non-ambulatory elective orthopedic surgery. METHODS: At a single specialty orthopedic hospital, we identified all in-hospital postoperative patients who were transferred to a higher level of medical care ((PACU) post-anesthesia care unit)...
February 2016: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Sunil Sharma, Paul Mather, Ankit Gupta, Gordon Reeves, Sharon Rubin, Raphael Bonita, Anindita Chowdhury, Raymond Malloy, Leslee Willes, David Whellan
Rehospitalization for congestive heart failure (CHF) is high within 6 months of discharge. Sleep disordered breathing (SDB) is common and underdiagnosed condition in patients with CHF. We hypothesized that early recognition and treatment of SDB in hospitalized patients with CHF will reduce hospital readmissions and emergency room visits. Patients admitted for CHF underwent overnight polysomnography within 4 weeks of discharge. Patients diagnosed with SDB were provided therapy with positive airway pressure therapy...
March 15, 2016: American Journal of Cardiology
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