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Pediatric readmission

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https://www.readbyqxmd.com/read/29352663/early-versus-delayed-closure-of-bladder-exstrophy-a-national-surgical-quality-improvement-program-pediatric-analysis
#1
J J Ahn, M Shnorhavorian, C Katz, A B Goldin, P A Merguerian
INTRODUCTION: Delayed closure of bladder exstrophy has become more popular; however, there is limited the evidence of its success. Existing literature focuses on intermediate and long-term outcomes, and short-term postoperative outcomes are limited by the small number of cases and varying follow-up methods. OBJECTIVE: The objectives of the current study were to: 1) compare 30-day complications after early and delayed closure of bladder exstrophy, and 2) evaluate practice patterns of bladder exstrophy closure...
December 15, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29340829/trends-and-surgical-outcomes-of-laparoscopic-versus-open-pyloromyotomy
#2
William C Kethman, Alex H S Harris, Mary T Hawn, James K Wall
BACKGROUND: Hypertrophic pyloric stenosis (HPS) is one of the most common pediatric illnesses necessitating surgical intervention. Controversy remains over the optimal surgical approach between laparoscopic pyloromyotomy (LP) and open pyloromyotomy (OP). LP has gained acceptance for management of HPS in an era of expanding minimal access surgical approaches to pediatric conditions. Several studies suggest advantages of LP over OP; however, selection bias and small sample sizes remain a concern...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29336798/hospital-readmissions-in-children-with-pulmonary-hypertension-a-multi-institutional-analysis
#3
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/29329165/repeat-rapid-response-events-in-children-characteristics-and-outcomes
#4
Kristen M Meulmester, Nancy Jaimon, Aarti C Bavare
OBJECTIVE: We describe the characteristics and outcomes of pediatric repeat rapid response events within a single hospitalization. We hypothesized that triggers for repeat rapid response and initial rapid response events are similar, and repeat rapid response events are associated with high prevalence of medical complexity and worse outcomes. DESIGN: A 3-year retrospective study. SETTING: High-volume tertiary academic pediatric hospital. PATIENTS: All rapid response events were reviewed to identify repeat rapid response events...
January 11, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29314789/risk-factors-for-hospitalizations-due-to-bacterial-respiratory-tract-infections-after-tracheotomy
#5
Christopher J Russell, Cary Thurm, Matt Hall, Tamara D Simon, Michael N Neely, Jay G Berry
OBJECTIVE: Identify characteristics associated with hospital readmission due to bacterial respiratory tract infections (bRTI) after tracheotomy. STUDY DESIGN: Retrospective study of 8009 children 0-17 years undergoing tracheotomy from 2007 to 2013 at 48 children's hospitals in the Pediatric Health Information System database. The primary outcome was first hospital admission after tracheotomy for bRTI (ie, primary diagnosis of bRTI or a primary diagnosis of bRTI symptom and secondary diagnosis of bRTI)...
January 4, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29295661/neonatal-hyperbilirubinemia-secondary-to-combined-anti-e-and-anti-c-isoimmunisation-a-literature-review
#6
Deepak Sharma, Nazanin Farahbakhsh
A term male infant was admitted at 48 hours of postnatal life to the neonatal unit for jaundice. The investigation showed total serum bilirubin (TSB) of 17.1 mg/dl, haemoglobin of 11 g/dl, reticulocyte count of 9.5% and peripheral smear was suggestive of macrocytic, normochromic red blood cell (RBC) with target cells and multiple spherocytes with occasional nucleated RBC. The infant's blood group was B positive. Direct antiglobulin test was strongly positive by gel method (3+). Mother's blood group was B positive and indirect antiglobulin test was positive when tested postnatally...
January 2, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29287880/revisits-after-pediatric-tracheotomy-airway-concerns-result-in-returns
#7
Sophie Shay, Nina L Shapiro, Neil Bhattacharyya
OBJECTIVES: Children undergoing tracheotomy represent a medically vulnerable patient population, and understanding the reasons for revisiting the hospital setting following tracheotomy is critical for improving the quality of care for these patients. This study aims to investigate the incidence and characteristics of revisits following pediatric tracheotomy. METHODS: Cross-sectional, population-based study using state databases. The State Inpatient Databases and State Emergency Department Databases for California, Florida, Iowa and New York 2010-11 were linked and examined for cases of pediatric tracheotomy (patients < 18...
January 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29283967/pediatric-appendicitis-is-referral-to-a-regional-pediatric-center-necessary
#8
Maggie M Hodges, Clay Cothren Burlew, Shannon N Acker, Ernest E Moore, Genie E Roosevelt, Anna Schubert, Lauren R S Hill, David A Partrick, Denis Bensard
BACKGROUND: Acute appendicitis is the most common emergent surgical procedure performed among children in the US, with an incidence exceeding 80,000 cases per year. Appendectomies are often performed by both pediatric surgeons and adult general/trauma acute care surgeons (TACS surgeons). We hypothesized that children undergoing appendectomy for acute appendicitis have equivalent outcomes whether a pediatric surgeon or a TACS surgeon performs the operation. METHODS: A retrospective chart review was performed for patients 6-18 years of age, who underwent appendectomy at either a regional children's hospital (CHCO, n=241) or an urban safety net hospital (n=347) between July 2010 and June 2015...
December 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29280541/ventricular-arrhythmias-immediately-following-transcatheter-pulmonary-valve-implantation-a-cause-for-concern
#9
M Abigail Simmons, Robert W Elder, Veronika Shabanova, William Hellenbrand, Jeremy Asnes
BACKGROUND: Transcatheter pulmonary valve implantation (TPVI) has revolutionized the care of patients with congenital disorders of the right ventricular outflow tract (RVOT) and is increasingly being used in patients with native outflow tracts. This is the first study to specifically report the occurrence of ventricular arrhythmias in the immediate post-TPVI period. METHODS AND RESULTS: Medical records of all adult and pediatric patients who underwent TPVI at our institution between May 1, 2011 and March 1, 2016, were reviewed for the presence of clinically significant ventricular arrhythmias occurring within 30 days of TPVI...
December 27, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29276868/rational-drug-use-for-acute-bronchiolitis-in-emergency-care
#10
Metin Uysalol, Fatih Haşlak, Zeynep Güneş Özünal, Hayriye Vehid, Nedret Uzel
Uysalol M, Haşlak F, Özünal ZG, Vehid H, Uzel N. Rational drug use for acute bronchiolitis in emergency care. Turk J Pediatr 2017; 59: 155-161. Despite the large variety of inhaled treatment options of acute bronchiolitis, there is no generally agreed treatment regime. This study aimed to determine the most appropriate treatment option. This was a double-blind randomized prospective clinical trial and has been performed in emergency department. The mean age of the 378 infants included in the study was 7...
2017: Turkish Journal of Pediatrics
https://www.readbyqxmd.com/read/29237135/spontaneous-pneumothorax-in-children-national-management-strategies-and-outcomes
#11
Kibileri Williams, Tolulope A Oyetunji, Grace Hsuing, Richard J Hendrickson, Timothy B Lautz
INTRODUCTION: The timing of surgical intervention in the management of spontaneous pneumothorax remains controversial. The aim of this multicenter review was to compare management strategies and outcomes in children with spontaneous pneumothorax. METHODS: We retrospectively reviewed patients 10-19 years old in the Pediatric Health Information System admitted for spontaneous pneumothorax from 2010 to 2014. Three treatment groups were identified based on initial hospital management-no intervention, initial chest tube placement, and operation; and outcomes were compared...
December 13, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29224755/factors-associated-with-30-day-all-cause-hospital-readmission-after-tracheotomy-in-pediatric-patients
#12
Helena Yu, Mary Rose Mamey, Christopher J Russell
OBJECTIVE: To determine factors associated with post-tracheotomy hospital readmission within 30 days of discharge. METHODS: Children 18 years and younger who underwent tracheotomy at Children's Hospital Los Angeles (CHLA) between 1/1/2005 and 12/31/2013 with at least 30 days of follow-up at CHLA were identified through ICD-9 procedure codes. Patient characteristics and covariates were obtained by linking manual chart review and administrative data. We used multivariate logistic regression to identify the independent association between risk factors and the primary outcome of 30-day all-cause same-hospital readmission...
December 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29210926/hospital-readmissions-after-pediatric-trauma
#13
Aline B Maddux, Peter E DeWitt, Peter M Mourani, Tellen D Bennett
OBJECTIVES: To determine the rate, etiology, and timing of unplanned and planned hospital readmissions and to identify risk factors for unplanned readmission in children who survive a hospitalization for trauma. DESIGN: Multicenter retrospective cohort study of a probabilistically linked dataset from the National Trauma Data Bank and the Pediatric Health Information System database, 2007-2012. SETTING: Twenty-nine U.S. children's hospitals...
November 28, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29208694/variation-in-care-and-clinical-outcomes-in-children-hospitalized-with-orbital-cellulitis
#14
Jessica L Markham, Matthew Hall, Jessica L Bettenhausen, Angela L Myers, Henry T Puls, Russell J McCulloh
OBJECTIVES: To describe variation in the care of children hospitalized with orbital cellulitis and to determine associations with length of stay (LOS), emergency department (ED) revisits, and hospital readmissions. METHODS: By using the Pediatric Health Information System, we performed a multicenter, retrospective study of children aged 2 months to 18 years with a primary International Classification of Diseases, Ninth Revision, Clinical Modification discharge diagnosis code for orbital cellulitis from 2007 to 2014...
December 5, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29189658/discharge-criteria-for-bronchiolitis-an-unmet-need
#15
Cristina Garcia-Mauriño, Melissa Moore-Clingenpeel, Rebecca Wallihan, Katalin Koranyi, Bavani Rajah, Tiffany Shirk, Maria Vegh, Octavio Ramilo, Asuncion Mejias
BACKGROUND: Admission criteria and standardized management strategies for bronchiolitis are addressed in several guidelines and have shown to be beneficial; however, guidance regarding discharge criteria is limited and widely variable. We assessed the impact on clinical outcomes of a discharge protocol for children < 2 years of age hospitalized with bronchiolitis in a tertiary care pediatric hospital. METHODS: In October 2013, a protocol to standardize the discharge of children with bronchiolitis was implemented in the infectious diseases (ID) ward, but not in other pediatric units caring for these children (non-ID)...
November 20, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29181038/implementing-an-oxygen-supplementation-and-monitoring-protocol-on-inpatient-pediatric-bronchiolitis-an-exercise-in-deimplementation
#16
Brian LeCleir, Leslie Jurecko, Alan T Davis, Nicholas J Andersen, Dominic Sanfilippo, Surender Rajasekaran, Anthony Olivero
Aim: Our goal in this study is to evaluate the effectiveness of our oxygen (O2) protocol to reduce length of stay (LOS) for children hospitalized with bronchiolitis. Methods: In this retrospective cohort study, the outcomes of children ≤ 24 months old that were admitted with bronchiolitis and placed on the O2 protocol were compared to historical controls. The primary outcome was hospital length of stay. Secondary outcomes were duration of O2 supplementation, rates of pediatric intensive care unit transfer, and readmission...
2017: International Journal of Pediatrics
https://www.readbyqxmd.com/read/29174431/pediatric-thyroid-cancer-patients-referred-to-high-volume-facilities-have-improved-short-term-outcomes
#17
Linda M Youngwirth, Mohamed A Adam, Samantha M Thomas, Sanziana A Roman, Julie A Sosa, Randall P Scheri
BACKGROUND: Thyroid cancer is the most common endocrine malignancy in children, albeit still rare. This study sought to measure the association between outcomes and case volume of the treatment facility for pediatric patients with thyroid cancer. METHODS: The National Cancer Data Base (1998-2011) was queried for all pediatric patients (age ≤ 18 years) with thyroid cancer. Demographic, clinical, and pathologic features were evaluated for all patients. Case volume of the treating facility was defined as the number of pediatric thyroid cancer patients at that facility during the study period...
November 22, 2017: Surgery
https://www.readbyqxmd.com/read/29159844/incidence-and-predictors-of-30-day-postoperative-readmission-in-children
#18
Daniel Vo, David Zurakowski, David Faraoni
BACKGROUND: Hospital readmissions are being used as a quality metric for hospital reimbursement without a clear understanding of the factors that contribute to readmission. OBJECTIVE: The objective of this study was to report the incidence of 30-day postsurgical readmission in children, identify the predictors for readmission, and create an algorithm to identify high-risk children. METHODS: Data from the 2012-2014 Pediatric database of the American College of Surgeons National Surgical Quality Improvement Program were analyzed using univariable and multivariable logistical regression analysis...
November 20, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29157923/outcomes-of-laparoscopic-and-open-surgery-in-children-with-and-without-congenital-heart-disease
#19
David I Chu, Jonathan M Tan, Peter Mattei, Allan F Simpao, Andrew T Costarino, Aseem R Shukla, Joseph W Rossano, Gregory E Tasian
BACKGROUND: Children with congenital heart disease (CHD) often require noncardiac surgery. We compared outcomes following open and laparoscopic intraabdominal surgery among children with and without CHD. METHODS: We performed a retrospective cohort study using the 2013-2015 National Surgical Quality Improvement Project-Pediatrics. We matched 45,012 children <18years old who underwent laparoscopic surgery to 45,012 children who underwent open surgery. We determined the associations between laparoscopic (versus open) surgery and 30-day mortality, in-hospital mortality, 30-day morbidity, and postoperative length-of-stay...
November 17, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29125442/long-term-outcomes-after-surgical-treatment-of-pediatric-neurogenic-thoracic-outlet-syndrome
#20
Jennifer Hong, Jared M Pisapia, Zarina S Ali, Austin J Heuer, Erin Alexander, Gregory G Heuer, Eric L Zager
OBJECTIVE Neurogenic thoracic outlet syndrome (nTOS) is an uncommon compression syndrome of the brachial plexus that presents with pain, sensory changes, and motor weakness in the affected limb. The authors reviewed the clinical presentations and outcomes in their series of pediatric patients with surgically treated nTOS over a 6-year period. METHODS Cases of nTOS in patients age 18 years or younger were extracted for analysis from a prospective database of peripheral nerve operations. Baseline patient characteristics, imaging and neurophysiological data, operative findings, and outcomes and complications were assessed...
November 10, 2017: Journal of Neurosurgery. Pediatrics
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