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https://www.readbyqxmd.com/read/29350768/diet-affects-gut-microbiota-and-modulates-hospitalization-risk-differentially-in-an-international-cirrhosis-cohort
#1
Jasmohan S Bajaj, Ramazan Idilman, Leila Mabudian, Matthew Hood, Andrew Fagan, Dilara Turan, Melanie B White, Fatih Karakaya, Jessica Wang, Rengül Atalay, Phillip B Hylemon, Edith A Gavis, Robert Brown, Leroy R Thacker, Chathur Acharya, Douglas M Heuman, Masoumeh Sikaroodi, Patrick M Gillevet
The relative ranking of cirrhosis-related deaths differs between high/middle-income countries. Gut microbiome is affected in cirrhosis and related to diet. Our aim was to determine the effect of differing dietary habits on gut microbiota and clinical outcomes. METHODS: Outpatient compensated/decompensated cirrhotics and controls from Turkey and USA underwent dietary and stool microbiota analysis. Cirrhotics were followed till 90-day hospitalizations. Shannon diversity and multi-variable determinants (Cox and binary logistic) of microbial diversity and hospitalizations were studied within/between groups...
January 19, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29343987/performance-of-the-lace-index-to-predict-30-day-hospital-readmissions-in-patients-with-chronic-obstructive-pulmonary-disease
#2
Maryam A Hakim, Frances L Garden, Matthew D Jennings, Claudia C Dobler
Background and objective: Patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease (COPD) have a high 30-day hospital readmission rate, which has a large impact on the health care system and patients' quality of life. The use of a prediction model to quantify a patient's risk of readmission may assist in directing interventions to patients who will benefit most. The objective of this study was to calculate the rate of 30-day readmissions and evaluate the accuracy of the LACE index (length of stay, acuity of admission, co-morbidities, and emergency department visits within the last 6 months) for 30-day readmissions in a general hospital population of COPD patients...
2018: Clinical Epidemiology
https://www.readbyqxmd.com/read/29340924/impact-of-preoperative-opioid-use-after-emergency-general-surgery
#3
Young Kim, Alexander R Cortez, Koffi Wima, Vikrom K Dhar, Krishna P Athota, Jason J Schrager, Timothy A Pritts, Michael J Edwards, Shimul A Shah
BACKGROUND: Preoperative exposure to narcotics has recently been associated with poor outcomes after elective major surgery, but little is known as to how preoperative opioid use impacts outcomes after common, emergency general surgical procedures (EGS). METHODS: A high-volume, single-center analysis was performed on patients who underwent EGS from 2012 to 2013. EGS was defined as the seven emergent operations that account for 80% of the national burden. Preoperative opioid use was defined as having an active opioid prescription within 7 days prior to surgery...
January 16, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29339536/length-of-stay-and-hospital-revisit-after-bacterial-tracheostomy-associated-respiratory-tract-infection-hospitalizations
#4
Christopher J Russell, Mary R Mamey, Joyce Y Koh, Sheree M Schrager, Michael N Neely, Susan Wu
OBJECTIVES: To identify factors associated with longer length of stay (LOS) and higher 30-day hospital revisit rates for children hospitalized with bacterial tracheostomy-associated respiratory tract infections (bTARTIs). METHODS: This was a multicenter, retrospective cohort study using administrative data from the Pediatric Health Information System database between 2007 and 2014 of patients 30 days to 17 years old with a principal discharge diagnosis of bTARTI or a principal discharge diagnosis of bTARTI symptoms with a secondary diagnosis of bTARTI...
January 16, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29336798/hospital-readmissions-in-children-with-pulmonary-hypertension-a-multi-institutional-analysis
#5
Jordan D Awerbach, George B Mallory, Shelly Kim, Antonio G Cabrera
OBJECTIVE: To assess the rate of and risk factors for 30-day hospital readmission in children with pulmonary hypertension. STUDY DESIGN: The Pediatric Health Information System database was analyzed for patients ≤18 years old with pulmonary hypertension (International Classification of Diseases, Ninth Revision, diagnosis codes of 416.0, 416.1, 416.8, or 416.9) admitted from 2005 through 2014. A generalized hierarchical regression model was used to determine significant ORs and 95% CIs associated with 30-day readmission...
January 12, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29327310/c-reactive-protein-on-postoperative-day-1-is-a-reliable-predictor-of-pancreas-specific-complications-after-pancreaticoduodenectomy
#6
Théophile Guilbaud, David Jérémie Birnbaum, Coralie Lemoine, Mircea Chirica, Olivier Risse, Stéphane Berdah, Edouard Girard, Vincent Moutardier
BACKGROUND: Postoperative pancreatic fistula and pancreas-specific complications have a significant influence on patient management and outcomes after pancreatoduodenectomy. The aim of the study was to assess the value of serum C-reactive protein on the postoperative day 1 as early predictor of pancreatic fistula and pancreas-specific complications. METHODS: Between 2013 and 2016, 110 patients underwent pancreaticoduodenectomy. Clinical, biological, intraoperative, and pathological characteristics were prospectively recorded...
January 4, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29322872/a-collaborative-approach-to-improve-consistent-use-of-procalcitonin-in-lower-respiratory-tract-infections
#7
Alexander R Levine, Robyn Riggott, Kristela Vulaj, Tera R Falcetti, Syed Ali, Gagandeep Singh
BACKGROUND: Procalcitonin (PCT) is a biomarker that can help differentiate bacterial from viral infections and has been extensively studied in patients with sepsis and pneumonia to guide antibiotic therapy. However, there is poor adherence to prescribed algorithms when used to discontinue antibiotics in the real world. A quality improvement project was implemented to increase consistent use of PCT. OBJECTIVE: To evaluate use of PCT and impact on antibiotic length of therapy (LOT) preimplementation and postimplementation of a quality improvement initiative...
January 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29321135/acute-myocardial-infarction-readmission-risk-prediction-models-a-systematic-review-of-model-performance
#8
Lauren N Smith, Anil N Makam, Douglas Darden, Helen Mayo, Sandeep R Das, Ethan A Halm, Oanh Kieu Nguyen
BACKGROUND: Hospitals are subject to federal financial penalties for excessive 30-day hospital readmissions for acute myocardial infarction (AMI). Prospectively identifying patients hospitalized with AMI at high risk for readmission could help prevent 30-day readmissions by enabling targeted interventions. However, the performance of AMI-specific readmission risk prediction models is unknown. METHODS AND RESULTS: We systematically searched the published literature through March 2017 for studies of risk prediction models for 30-day hospital readmission among adults with AMI...
January 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29318080/race-and-rehabilitation-destination-after-elective-total-hip-arthroplasty-analysis-of-a-large-regional-data-set
#9
Ernest R Vina, Michael J Kallan, Aliya Collier, Charles L Nelson, Said A Ibrahim
Background: Three-quarters of patients who undergo total hip replacement (THR) receive postsurgical rehabilitation care in an inpatient rehabilitation facility (IRF), a skilled nursing facility (SNF), or through a home health agency. The objectives of this study are to examine racial differences where THR recipients receive postsurgical rehabilitation care and determine whether discharge destination is associated with hospital readmission. Methods: Using the Pennsylvania Health Care Cost Containment Council database, we selected African American (AA) or white adults who underwent THR surgery (n = 68,016)...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29305381/thirty-day-hospital-readmissions-among-mechanically-ventilated-emergency-department-patients
#10
David B Page, Anne M Drewry, Enyo Ablordeppey, Nicholas M Mohr, Marin H Kollef, Brian M Fuller
BACKGROUND: Unplanned 30-day readmissions have a negative impact on patients and healthcare systems. Mechanically ventilated ED patients are at high risk for complications, but factors associated with readmission are unknown. OBJECTIVE: (1) Determine the rate of 30-day hospital readmission for ED patients receiving mechanical ventilation. (2) Identify associations between ED-based risk factors and readmission. DESIGN: Retrospective cohort study...
January 5, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29305023/early-vs-late-fracture-fixation-in-severe-head-and-orthopedic-injuries
#11
Yuan Zhang, Kai Sun, Yuling Wang, Yafei Qin, Hui Li
BACKGROUND: Patients suffered from craniocerebral trauma with extermities fracture is one of the most common multiple injuries.Actually there is no comparative study demonstrating advantages of early or delayed treatment of skeletal injuries. PURPOSES: To conduct a meta-analysis with studies published in full text to demonstrate database to show the associations of perioperative, postoperative outcomes of early fracture fixation(EFF) and late fracture fixation(LFF) for patients with severe head and orthopedic injuries to provide the predictive diagnosis for clinic...
December 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29298280/complete-objective-response-stable-for-5-years-with-the-di-bella-method-of-multiple-metastatic-carcinoma-of-the-breast
#12
Giuseppe Di Bella, Biagio Colori, Rosilde Toscano
Breast cancer is the most common cancer and the leading cause of cancer death among women. Despite all efforts, about 11,939 deaths and 50,000 new diagnoses for breast cancer were estimated among Italian women in 2016. Therefore new approaches are needed to improve the survival and higher remission rates. We present a case of a woman with carcinoma of the breast and multiple metastases after right mastectomy, axillary dissection, repeated cycles of chemo and radiotherapy, and estrogen block. Biological method formulated by Prof...
December 4, 2017: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/29289543/comparison-of-3-frailty-instruments-in-a-geriatric-acute-care-setting-in-a-low-middle-income-country
#13
Sumika Mori Lin, Márlon Juliano Romero Aliberti, Sileno de Queiroz Fortes-Filho, Juliana de Araújo Melo, Ivan Aprahamian, Claudia Kimie Suemoto, Wilson Jacob Filho
OBJECTIVE: Comparison of frailty instruments in low-middle income countries, where the prevalence of frailty may be higher, is scarce. In addition, less complex diagnostic tools for frailty are important in these settings, especially in acutely ill patients, because of limited time and economic resources. We aimed to compare the performance of 3 frailty instruments for predicting adverse outcomes after 1 year of follow-up in older adults with an acute event or a chronic decompensated disease...
December 27, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29288657/a-pragmatic-preoperative-prediction-score-for-non-home-discharge-after-cardiac-surgery
#14
Jenna Stuebe, Jessica Rydingsward, Heather Lander, Jillian Ng, Xinling Xu, Tsuyoshi Kaneko, Prem Shekar, Jochen D Muehlschlegel, Simon C Body
BACKGROUND: Targeted rehabilitation of patients at risk for non-home discharge (NHD) following surgery is an appealing area for quality improvement. We sought to identify the primary predictors of NHD following cardiac surgery in order to generate a robust preoperative prediction tool for those at greatest risk. METHODS: The medical records of 5,253 patients undergoing cardiac surgery between 1/1/2012 - 3/31/2016 were reviewed. Two models of NHD were created; a preoperative model using only preoperative predictors and a postoperative model using the same preoperative predictors, and including postoperative adverse outcomes and duration of hospital stay...
December 27, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29283493/the-checklist-of-unit-behaviors-cub-validation-within-a-canadian-outpatient-day-hospital-program
#15
Marlene Taube-Schiff, Christo El Morr, Alyssa Counsell, Aiden Mehak, Jackie Gollan
INTRODUCTION: We evaluated the Checklist of Unit Behaviors (CUB) questionnaire in a novel mental health setting: a day hospital within a large acute care general hospital. The CUB measures two factors, Avoidance or Approach, of the patients' engagement with the treatment milieu within the previous 24 hours. AIM: A Confirmatory Factor Analysis (CFA) was conducted to validate the CUB's original two factor structure in an outpatient day program. METHOD: Psychiatric outpatients (N=163) completed the CUB daily while participating in a day hospital program in Toronto, Canada...
December 28, 2017: Journal of Psychiatric and Mental Health Nursing
https://www.readbyqxmd.com/read/29278647/effectiveness-of-a-stunting-recovery-program-for-children-treated-in-a-specialized-center
#16
Nassib B Bueno, Catia B Lisboa, Ana G Clemente, Renata T Antunes, Ana L Sawaya, Telma T Florêncio
BACKGROUND: Stunting is still very prevalent in many poor and developing regions in the world. This study assessed the effectiveness of a stunting recovery program in children and its associated factors. METHODS: Retrospective study conducted in a center of stunting recovery. There, children stayed in a day-hospital system (9 h/day; 5 days/week), and received five meals/day, providing 80% of their energetic daily needs. The main outcome was the stunting recovery rate (i...
December 20, 2017: Pediatric Research
https://www.readbyqxmd.com/read/29273612/interprofessional-care-collaboration-for-patients-with-heart-failure
#17
Amanda Boykin, Danielle Wright, Lydia Stevens, Lauren Gardner
PURPOSE: An innovative collaborative care model to improve transitions of care (TOC) for patients with heart failure (HF) is described. SUMMARY: As part of a broad effort by New Hanover Regional Medical Center (NHRMC) to reduce avoidable 30-day hospital readmissions and decrease associated healthcare costs through a team-centered, value-based approach to patient care, an interprofessional team was formed to help reduce hospital readmissions among discharged patients with HF...
January 1, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29261248/investigating-the-impact-of-intervention-refusal-on-hospital-readmission
#18
Alexis Coulourides Kogan, Eileen Koons, Susan Enguidanos
OBJECTIVES: To identify characteristics and readmission risks associated with opting out of a social work-driven transition intervention. STUDY DESIGN: Secondary data analysis of a randomized controlled pilot study at a large nonprofit urban community hospital. METHODS: Hospitalized English-speaking, cognitively intact adults 65 years or older with expected discharge back to the community were eligible for enrollment. Additionally, patients met at least 1 of the 3 criteria: 1) 75 years or older, 2) taking 5 or more medications, or 3) had 1 or more prior inpatient stays or emergency department visits in the previous 6 months...
December 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29251293/impact-of-a-barcode-medication-administration-system-on-patient-safety%C3%A2
#19
Marta Macias, Francisco A Bernabeu-Andreu, Ignacio Arribas, Fatima Navarro, Gema Baldominos
OBJECTIVES: To determine the impact of barcode medication administration (BCMA) on the incidence of medication administration errors among patients in an onco-hematology day hospital and to identify the characteristics of medication errors in that setting.
. SAMPLE & SETTING: 715 patients treated in the onco-hematology day unit at the Príncipe de Asturias University Hospital in Madrid, Spain.
. METHODS & VARIABLES: A between-groups, pre-/postintervention study was conducted...
January 1, 2018: Oncology Nursing Forum
https://www.readbyqxmd.com/read/29251207/perioperative-outcomes-from-the-prospective-multicenter-least-invasive-fast-track-evar-life-registry
#20
Zvonimir Krajcer, Venkatesh G Ramaiah, Esteban A Henao, D Chris Metzger, Wayne K Nelson, Mohammed M Moursi, Hiranya A Rajasinghe, Raed Al-Dallow, Larry E Miller
PURPOSE: To determine the feasibility, perioperative resource utilization, and safety of a fast-track endovascular aneurysm repair (EVAR) protocol in well-selected patients. METHODS: Between October 2014 and May 2016, the LIFE (Least Invasive Fast-track EVAR) registry ( ClinicalTrials.gov identifier NCT02224794) enrolled 250 patients (mean age 73±8 years; 208 men) in a fast-track EVAR protocol comprised of bilateral percutaneous access using the 14-F Ovation stent-graft, no general anesthesia, no intensive care unit (ICU) admission, and next-day discharge...
December 1, 2017: Journal of Endovascular Therapy
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