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Pediatric readmission

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https://www.readbyqxmd.com/read/28522604/hospital-level-variation-in-practice-patterns-and-patient-outcomes-for-pediatric-patients-hospitalized-with-functional-constipation
#1
Jamie Librizzi, Samuel Flores, Keith Morse, Kelly Kelleher, Jodi Carter, Ryan Bode
BACKGROUND AND OBJECTIVE: Constipation is a common pediatric condition with a prevalence of 3% to 5% in children aged 4 to 17 years. Currently, there are no evidence-based guidelines for the management of pediatric patients hospitalized with constipation. The primary objective was to evaluate practice patterns and patient outcomes for the hospital management of functional constipation in US children's hospitals. METHODS: We conducted a multicenter, retrospective cohort study of children aged 0 to 18 years hospitalized for functional constipation from 2012 to 2014 by using the Pediatric Health Information System...
May 18, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28483166/risk-factors-for-nonelective-30-day-readmission-in-pediatric-assault-victims
#2
Jessica L Buicko, Joshua Parreco, Brent A Willobee, Amy E Wagenaar, Juan E Sola
PURPOSE: Hospital readmission in trauma patients is associated with significant morbidity and increased healthcare costs. There is limited published data on early hospital readmission in pediatric trauma patients. As presently in healthcare outcomes and readmissions rates are increasingly used as hospital quality indicators, it is paramount to recognize risk factors for readmission. We sought to identify national readmission rates in pediatric assault victims and identify the most common readmission diagnoses among these patients...
April 23, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28476461/adding-social-determinant-data-changes-children-s-hospitals-readmissions-performance
#3
Marion R Sills, Matthew Hall, Gretchen J Cutler, Jeffrey D Colvin, Laura M Gottlieb, Michelle L Macy, Jessica L Bettenhausen, Rustin B Morse, Evan S Fieldston, Jean L Raphael, Katherine A Auger, Samir S Shah
OBJECTIVES: To determine whether social determinants of health (SDH) risk adjustment changes hospital-level performance on the 30-day Pediatric All-Condition Readmission (PACR) measure and improves fit and accuracy of discharge-level models. STUDY DESIGN: We performed a retrospective cohort study of all hospital discharges meeting criteria for the PACR from 47 hospitals in the Pediatric Health Information database from January to December 2014. We built four nested regression models by sequentially adding risk adjustment factors as follows: chronic condition indicators (CCIs); PACR patient factors (age and sex); electronic health record-derived SDH (race, ethnicity, payer), and zip code-linked SDH (families below poverty level, vacant housing units, adults without a high school diploma, single-parent households, median household income, unemployment rate)...
May 2, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28469533/effect-of-a-pediatric-prescription-medication-discharge-program-on-reducing-hospital-readmission-rates
#4
Laura A Leathers, Kristy L Brittain, Kelly Crowley
OBJECTIVES: To evaluate the pediatric prescription medication discharge delivery and counseling program, implemented at an 186-bed children's hospital integrated within a larger academic medical center, and its effectiveness on reducing hospital readmissions. METHODS: This study was a retrospective chart review of existing data in the electronic medical record from patients <21 years of age who were discharged from our institution between September 1, 2014, and November 30, 2014...
March 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28463634/comparing-30-day-morbidity-and-mortality-in-pediatric-and-adult-otologic-surgery
#5
Zachary G Schwam, Elias Michaelides, Jennifer R Schwam, Phoebe Kuo, Michael A Hajek, Benjamin L Judson, Christopher Schutt
Objective To determine differences in timing and rate of postoperative adverse events among pediatric and adult populations undergoing specific otologic procedures. Study Design Administrative database study. Setting Multi-institutional database. Subjects and Methods The National Surgical Quality Improvement Program (NSQIP) and NSQIP-Pediatric (NSQIP-P) were used to extract data from 819 adults (years 2005-2010) and 7020 children (years 2012-2014) undergoing tympanoplasty and (tympano)mastoidectomy, respectively...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28450309/decreasing-exposure-to-radiation-surgical-risk-and-costs-for-pediatric-complicated-pneumonia-a-guideline-evaluation
#6
Rachel D Quick, Michael J Auth, Marisol Fernandez, Tory Meyer, Kathryn G Merkel, Lynn M Thoreson, Sarmistha B Hauger
OBJECTIVES: This report describes the creation and successful implementation of a complicated pneumonia care algorithm at our institution. Outcomes are measured for specific goals of the algorithm: to decrease radiation exposure, surgical risk, and patient charges without adversely affecting clinical outcomes. METHODS: We describe steps involved in algorithm creation and implementation at our institution. To depict outcomes of the algorithm, we completed a retrospective cohort study of hospitalized pediatric patients with a diagnosis of complicated pneumonia at a single institution between January 2010 and April 2016 who met criteria for the algorithm...
April 27, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28445250/enteric-fever-in-children-in-western-sydney-australia-2003-2015
#7
Ameneh Khatami, Fouzia Khan, Kristine K Macartney
BACKGROUND: Enteric fever is a vaccine-preventable disease with cases in Australia predominantly acquired overseas. The aim of this study was to define the burden of enteric fever in children presenting to a pediatric hospital in Western Sydney between 2003 and 2015. METHODS: Cases between January 2003 and December 2013 were ascertained through medical records using ICD-coded discharge diagnoses, cross-referenced with microbiology laboratory data for all isolates of Salmonella enterica serovar Typhi (S...
April 25, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28438375/racial-and-ethnic-differences-in-pediatric-readmissions-for-common-chronic-conditions
#8
Kavita Parikh, Jay Berry, Matt Hall, Grant M Mussman, Amanda Montalbano, Joanna Thomson, Rustin Morse, Karen M Wilson, Samir S Shah
OBJECTIVE: To compare the timing and magnitude of variation of pediatric readmission rates across race/ethnicity for selected chronic conditions: asthma, diabetes, seizures, migraines, and depression. STUDY DESIGN: Retrospective analysis of hospitalizations at 48 children's hospitals in the 2013 Pediatric Health Information System database for children (ages 0-18 years) admitted for asthma (n = 36 910), seizure (n = 35 361), diabetes (n = 12 468), migraine (n = 5882), and depression (n = 5132)...
April 21, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28434635/readmissions-unplanned-emergency-room-visits-and-surgical-retreatment-rates-after-anti-reflux-procedures
#9
Hsin-Hsiao S Wang, Rohit Tejwani, Steven Wolf, John S Wiener, Jonathan C Routh
INTRODUCTION/BACKGROUND: The choice between endoscopic injection (EI) and ureteroneocystotomy (UNC) for surgical correction of vesicoureteral reflux (VUR) is controversial. OBJECTIVE: To compare postoperative outcomes of EI vs UNC. STUDY DESIGN: This study reviewed linked inpatient (SID), ambulatory surgery (SASD), and emergency department (SEDD) data from five states in the United States (2007-10) to identify pediatric patients with primary VUR undergoing EI or UNC as an initial surgical intervention...
April 7, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28433362/effect-of-preadmission-bowel-preparation-on-outcomes-of-elective-colorectal-procedures-in-young-children
#10
Guillermo J Ares, Irene Helenowski, Catherine J Hunter, Marybeth Madonna, Marleta Reynolds, Timothy Lautz
BACKGROUND: The utility of mechanical bowel preparation (MBP) to minimize infectious complications in elective colorectal surgery is contentious. Though data is scarce in children, adult studies suggest a benefit to MBP when administered with oral antibiotics (OAB). METHODS: After IRB approval, the Pediatric Health Information System (PHIS) was queried for young children undergoing elective colon surgery from 2011 to 2014. Patients were divided into: no bowel preparation (Group 1), MBP (Group 2), and MBP plus OAB (Group 3)...
March 30, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28432613/pediatric-tonsillectomy-is-a-resource-intensive-procedure-a-study-of-canadian-health-administrative-data
#11
Kimmo T T Murto, Sherri L Katz, Daniel I McIsaac, Matthew A Bromwich, Régis Vaillancourt, Carl van Walraven
BACKGROUND: The majority of pediatric surgeries are performed in a day surgery setting. The rate of adverse postoperative outcomes and the factors that influence them are poorly described in the Canadian setting. Concerns about the safety of adenotonsillectomy (AT) have been raised. The objective of this Ontario-based study was to determine the rates and risks of hospital readmission, emergency department (ED) visits, or deaths within 30 days following common pediatric surgeries, with an emphasis on AT...
April 21, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28420262/impact-of-an-educational-intervention-to-improve-physician-adherence-to-bronchiolitis-clinical-practice-guidelines-a-pre-post-intervention-study
#12
Marquita C Genies, Julia M Kim, Kristina Pyclik, Suzanne Rossi, Natalie Spicyn, Janet R Serwint
Bronchiolitis is the leading cause of infant hospitalizations in the United States. Despite clinical practice guidelines discouraging the utilization of non-evidence-based therapies, there continues to be wide variation in care and resource utilization. A pre-post physician focused educational intervention was conducted with the aims to reduce the use of non-evidence-based medical therapies, including bronchodilators, among patients admitted for bronchiolitis. Among patients meeting inclusion criteria (pre: n = 45; post: n = 47), bronchodilator use decreased by 50% ( P < ...
April 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28419343/utilizing-a-modified-care-coordination-measurement-tool-to-capture-value-for-a-pediatric-outpatient-parenteral-and-prolonged-oral-antibiotic-therapy-program
#13
Louise E Vaz, Cindi L Farnstrom, Kimberly K Felder, Judith Guzman-Cottrill, Hannah Rosenberg, Richard C Antonelli
Background.: Outpatient parenteral or prolonged oral antibiotic therapy (OPAT) programs reduce inpatient healthcare costs by shifting care to outpatient settings. Care coordination (CC) is a necessary component to successfully transition patients. Our objective was to assess outcomes of provider time spent on nonreimbursable CC activities in a pediatric OPAT program. Methods.: We used a qualitative feasibility pilot design and modified the Care Coordination Measurement Tool...
April 17, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28419275/clinical-care-guideline-for-improving-pediatric-acute-musculoskeletal-infection-outcomes
#14
Murray D Spruiell, Justin Benjamin Searns, Travis C Heare, Jesse L Roberts, Erin Wylie, Laura Pyle, Nathan Donaldson, Jaime R Stewart, Heather Heizer, Jennifer Reese, Halden F Scott, Kelly Pearce, Colin J Anderson, Mark Erickson, Sarah K Parker
Background.: Acute pediatric musculoskeletal infections are common, leading to significant use of resources and antimicrobial exposure. In order to decrease variability and improve the quality of care, Children's Hospital Colorado implemented a clinical care guideline (CCG) for these infections. The purpose of this study is to evaluate clinical and resource outcomes PRE and POST this CCG. Methods.: Retrospective chart review evaluated patients admitted to a large pediatric quaternary referral center (CHCO) diagnosed with acute osteomyelitis, septic arthritis, pyomyositis, and/or musculoskeletal abscess prior to and after guideline implementation...
April 17, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28408077/does-timing-of-gastroschisis-repair-matter-a-comparison-using-the-acs-nsqip-pediatric-database
#15
Lori A Gurien, Melvin S Dassinger, Jeffrey M Burford, Marie E Saylors, Samuel D Smith
BACKGROUND: There is no consensus on optimal timing of gastroschisis repair. The 2012-2014 ACS NSQIP Pediatric Participant Use Data File was used to compare outcomes of primary versus staged gastroschisis repair. METHODS: Cases were divided into primary repair (0-1day) and staged repair (4-14days). Baseline characteristics and outcomes were compared for primary versus staged closure using Fisher's exact tests for categorical variables and Wilcoxon rank-sum tests for continuous variables...
February 21, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28390616/five-years-experience-with-outpatient-thyroglossal-duct-cyst-surgery
#16
Ana Coelho, Catarina Sousa, Ana Sofia Marinho, Joana Barbosa-Sequeira, João Ribeiro-Castro, Fátima Carvalho, João Moreira-Pinto
OBJECTIVES: Many pediatric surgeons feel uncomfortable doing Sistrunk procedure without drain placement and in an outpatient setting. This study aimed to review our pediatric surgery department's experience in managing thyroglossal duct cyst surgery and to prove feasibility and safety of Sistrunk procedure without drain placement in an outpatient setting. METHODS: A retrospective review was performed of all patients who underwent Sistrunk procedure, between January 2011 and December 2015, in our department...
May 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28346589/comparison-of-antibiotic-therapy-and-appendectomy-for-acute-uncomplicated-appendicitis-in-children-a-meta-analysis
#17
Libin Huang, Yuan Yin, Lie Yang, Cun Wang, Yuan Li, Zongguang Zhou
Importance: Antibiotic therapy for acute uncomplicated appendicitis is effective in adult patients, but its application in pediatric patients remains controversial. Objective: To compare the safety and efficacy of antibiotic treatment vs appendectomy as the primary therapy for acute uncomplicated appendicitis in pediatric patients. Data Sources: The PubMed, MEDLINE, EMBASE, and Cochrane Library databases and the Cochrane Controlled Trials Register for randomized clinical trials were searched through April 17, 2016...
May 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28341068/clinical-characteristics-of-pyogenic-flexor-tenosynovitis-in-pediatric-patients
#18
Christopher M Brusalis, Stephanie Thibaudeau, Robert B Carrigan, Ines C Lin, Benjamin Chang, Apurva S Shah
PURPOSE: To characterize the clinical presentation, common pathogens, antimicrobial susceptibility, and treatment methods associated with pyogenic flexor tenosynovitis (PFT) in pediatric patients. METHODS: Patients who underwent surgical treatment for PFT at a large tertiary-care children's hospital between 2001 and 2015 were identified. Descriptive summary statistics were reported on patient demographics, presenting symptoms and clinical examination features, culture results, treatment strategies, and early complications...
May 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28336475/intraoperative-rupture-of-ovarian-dermoid-cysts-in-the-pediatric-and-adolescent-population-should-this-change-your-surgical-management
#19
Krista J Childress, Gisselle Perez-Milicua, Julie Hakim, Oluyemisi Adeyemi-Fowode, Jennifer L Bercaw-Pratt, Xiomara M Santos, Jennifer E Dietrich
STUDY OBJECTIVE: 1) To determine the incidence of chemical peritonitis after cystectomy for ovarian dermoid cysts with intraoperative cyst rupture in the pediatric and adolescent population. 2) To examine the intraoperative and postoperative outcomes of cystectomies performed for ovarian dermoid cysts by laparoscopy and laparotomy, especially those with intraoperative cyst rupture. DESIGN: A retrospective cohort study of females who underwent ovarian cystectomy with proven ovarian dermoid pathology between July 2007 and July 2015...
March 20, 2017: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/28336042/acute-hematogenous-osteomyelitis-in-children-pathogenesis-diagnosis-and-treatment
#20
REVIEW
Shawn S Funk, Lawson A B Copley
Acute hematogenous osteomyelitis (AHO) in children is an ideal condition to study due to its representation of a wide spectrum of disorders that comprise pediatric musculoskeletal infection. Proper care for children with AHO is multidisciplinary and collaborative. AHO continues to present a significant clinical challenge due to evolving epidemiology and complex pathogenesis. A guideline-driven, multidisciplinary approach has been introduced and shown to effectively reduce hospital stay, improve the timing and selection of empirical antibiotic administration, reduce delay to initial MRI, reduce the rate of readmission, and shorten antibiotic duration...
April 2017: Orthopedic Clinics of North America
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