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https://www.readbyqxmd.com/read/29161667/pre-hospital-frailty-and-hospital-outcomes-in-adults-with-acute-respiratory-failure-requiring-mechanical-ventilation
#1
Aluko A Hope, Oriade Adeoye, Elizabeth H Chuang, S J Hsieh, Hayley B Gershengorn, Michelle N Gong
PURPOSE: We aimed to estimate the independent effect of pre-hospital frailty (PHF) on hospital mortality and prolonged hospital length of stay (pLOS) while adjusting for other patient level factors. METHODS: This is a cohort study of hospitalized adults with acute respiratory failure (ARF) who required invasive mechanical ventilation for ≥24h in 2013. We used inpatient/outpatient claims from a list of diagnoses from the year before index hospital admission to define PHF...
November 11, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29161192/patient-preferences-in-subglottic-stenosis-treatment-a-discrete-choice-experiment
#2
Matthew R Naunheim, Margaret L Naunheim, Vinay K Rathi, Ramon A Franco, Mark G Shrime, Phillip C Song
Objectives Subglottic stenosis can be addressed with several different surgical techniques, but patient preferences for these treatment modalities are poorly understood. Economic methods are increasingly being used to understand how patients make decisions. The objective of this pilot study was to assess preferences in subglottic stenosis treatment using patient-centric stated preference techniques. Study Design Discrete choice experiment (DCE). Setting Academic research facility. Subjects and Methods A computer-based DCE was administered in a monitored setting to volunteers from the general population...
November 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29160561/can-overnight-stenting-be-safely-eliminated-following-a-pharyngeal-flap-a-matched-comparison-study
#3
Andre M Wineland, Jareen Meinzen-Derr, Paul Willging
OBJECTIVE: Determine if overnight stenting is warranted after pharyngeal flap for management of velopharyngeal insufficiency (VPI) in pediatric patients METHODS: This is a retrospective age-matched cohort study from a single tertiary pediatric facility. Patients who underwent a posterior pharyngeal flap for VPI from January 1, 2013, to December 31, 2016, were included. Two equal groups were constructed based on when their nasal stents were removed, that is, postoperative day (POD) 0 or POD 1...
November 21, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29160424/effect-of-prophylactic-non-invasive-mechanical-ventilation-on-functional-capacity-after-heart-valve-replacement-a-clinical-trial
#4
Amaro Afrânio de Araújo-Filho, Manoel Luiz de Cerqueira-Neto, Lucas de Assis Pereira Cacau, Géssica Uruga Oliveira, Telma Cristina Fontes Cerqueira, Valter Joviniano de Santana-Filho
OBJECTIVE: During cardiac surgery, several factors contribute to the development of postoperative pulmonary complications. Non-invasive ventilation is a promising therapeutic tool for improving the functionality of this type of patient. The aim of this study is to evaluate the functional capacity and length of stay of patients in a nosocomial intensive care unit who underwent prophylactic non-invasive ventilation after heart valve replacement. METHOD: The study was a controlled clinical trial, comprising 50 individuals of both sexes who were allocated by randomization into two groups with 25 patients in each group: the control group and experimental group...
October 2017: Clinics
https://www.readbyqxmd.com/read/29160123/fast-tracking-for-total-knee-replacement-reduces-use-of-institutional-care-without-compromising-quality
#5
Konsta J Pamilo, Paulus Torkki, Mikko Peltola, Maija Pesola, Ville Remes, Juha Paloneva
Background and purpose - Fast-tracking shortens the length of the primary treatment period (length of stay, LOS) after total knee replacement (TKR). We evaluated the influence of the fast-track concept on the length of uninterrupted institutional care (LUIC) and other outcomes after TKR. Patients and methods - 4,256 TKRs performed in 4 hospitals between 2009-2010 and 2012-2013 were identified from the Finnish Hospital Discharge Register and the Finnish Arthroplasty Register. Hospitals were classified as fast track (Hospital A) and non-fast track (Hospitals B, C and D)...
November 21, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/29160093/comparison-of-fall-prediction-by-the-hessisch-oldendorf-fall-risk-scale-and-the-fall-risk-scale-by-huhn-in-neurological-rehabilitation-an-observational-study
#6
Olena Hermann, Simone B Schmidt, Melanie Boltzmann, Jens D Rollnik
OBJECTIVE: To calculate scale performance of the newly developed Hessisch Oldendorf Fall Risk Scale (HOSS) for classifying fallers and non-fallers in comparison with the Risk of Falling Scale by Huhn (FSH), a frequently used assessment tool. DESIGN: A prospective observational trail was conducted. SETTING: The study was performed in a large specialized neurological rehabilitation facility. SUBJECTS: The study population ( n = 690) included neurological and neurosurgery patients during neurological rehabilitation with varying levels of disability...
November 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/29159958/evaluation-of-a-low-risk-mild-traumatic-brain-injury-and-intracranial-hemorrhage-emergency-department-observation-protocol
#7
Brian J Yun, Pierre Borczuk, Lulu Wang, Stephen Dorner, Benjamin A White, Ali S Raja
OBJECTIVES: Among emergency physicians, there is wide variation in admitting practices for patients who suffered a mild traumatic brain injury (TBI) with an intracranial hemorrhage (ICH). The purpose of this study was to evaluate the effects of implementing a protocol in the emergency department (ED) observation unit for patients with mild TBI and ICH. METHODS: This retrospective cohort study was approved by the Institutional Review Board. Study subjects were patients ≥18 years of age with an International Classification of Diseases (ICD) code corresponding to a traumatic IC, and admitted to an ED observation unit (EDOU) of an urban, academic level 1 trauma center between February 1, 2015 and January 31, 2017...
November 20, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29159851/comparison-of-three-fixation-methods-in-treatment-of-tibial-fracture-in-adolescents
#8
REVIEW
Lixiang Lin, Yang Liu, Chuanlu Lin, Yifei Zhou, Yongzeng Feng, Xiaolong Shui, Kehe Yu, Xiaolang Lu, Jianjun Hong, Yang Yu
BACKGROUND: Tibial fractures are the most common musculoskeletal injury in adolescents. The optimal management of tibial fractures in adolescents is controversial. In this study, we compared the outcomes including complications of three fixation methods in tibial fractures of adolescents and explored the factors associated with the complications. METHODS: A retrospective cohort study about 83 diaphyseal tibial fractures in 79 children and adolescents, who were treated with plate fixation (PF), elastic stable intramedullary nail fixation (ESINF), or external fixation (EF), was conducted...
November 21, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29159552/the-effect-of-helicobacter-pylori-on-postoperative-outcomes-in-patients-undergoing-bariatric-surgery-a-systematic-review-and-meta-analysis
#9
REVIEW
Valentin Mocanu, Jerry T Dang, Noah Switzer, Daniel Skubleny, Xinzhe Shi, Chris de Gara, Daniel W Birch, Shahzeer Karmali
Helicobacter pylori (HP) occurs in 50% of people worldwide with higher rates reported in the bariatric population. HP has been associated with adverse outcomes following bariatric surgery; however, its true impact has not yet been defined. We aimed to systematically review the effect of HP on bariatric surgery outcomes. A comprehensive literature review was conducted yielding seven studies with 255,435 patients. Meta-analysis found comparable rates of bleeding, leak, hospital length of stay, and weight loss between HP-positive and HP-negative patients...
November 21, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29159166/laparoscopic-and-robotic-surgeries-for-patients-with-colorectal-cancer-who-have-had-a-previous-abdominal-surgery
#10
Soeun Park, Jeonghyun Kang, Eun Jung Park, Seung Hyuk Baik, Kang Young Lee
Purpose: The impact of previous abdominal surgery (PAS) on surgical outcomes from laparoscopic and robot surgeries is inconclusive. This study aimed to investigate the impact of PAS on perioperative outcomes from laparoscopic and robotic colorectal surgeries. Methods: From March 2007 to February 2014, a total of 612 and 238 patients underwent laparoscopic and robotic surgeries, respectively. Patients were divided into 3 groups: those who did not have a PAS (NPAS), those who had a major PAS, and those who had a minor PAS...
October 2017: Annals of Coloproctology
https://www.readbyqxmd.com/read/29158243/point-of-care-lactate-testing-for-sepsis-at-presentation-to-health-care-a-systematic-review-of-patient-outcomes
#11
Elizabeth Morris, David McCartney, Daniel Lasserson, Ann Van den Bruel, Rebecca Fisher, Gail Hayward
BACKGROUND: Lactate is measured in hospital settings to identify patients with sepsis and severe infections, and to guide initiation of early treatment. Point-of-care technology could facilitate measurement of lactate by clinicians in the community. However, there has been little research into its utility in these environments. AIM: To investigate the effect of using point-of-care lactate at presentation to health care on mortality and other clinical outcomes, in patients presenting with acute infections...
November 20, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29158075/intermediate-care-unit-after-cardiac-surgery-impact-on-length-of-stay-and-outcomes
#12
Carlos Labata, Teresa Oliveras, Elisabet Berastegui, Xavier Ruyra, Bernat Romero, Maria-Luisa Camara, Maria-Soledad Just, Jordi Serra, Ferran Rueda, Marc Ferrer, Cosme García-García, Antoni Bayes-Genis
INTRODUCTION AND OBJECTIVES: Current postoperative management of adult cardiac surgery often comprises transfer from the intensive care unit (ICU) to a conventional ward. Intermediate care units (IMCU) permit hospital resource optimization. We analyzed the impact of an IMCU on length of stay (both ICU and in-hospital) and outcomes (in-hospital mortality and 30-day readmissions) after adult cardiac surgery (IMCU-CS). METHODS: From November 2012 to April 2015, 1324 consecutive patients were admitted to a university hospital for cardiac surgery...
November 17, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29158058/regional-cerebral-oxygen-saturation-level-predicts-30-day-mortality-rate-after-left-ventricular-assist-device-surgery
#13
Soutik Ghosal, Jaimin Trivedi, James Chen, Michael P Rogers, Allen Cheng, Mark S Slaughter, Maiying Kong, Jiapeng Huang
OBJECTIVE: Left ventricular assist device (LVAD) surgery is complex, high risk, and expensive. The authors' hypothesis is baseline regional cerebral oxygen saturation (rSO2) might be a predictor of postoperative clinical outcomes. DESIGN: Retrospective review of 210 consecutive continuous flow LVAD patients between 2008 and 2014. The primary measure is 30-day mortality rate and secondary measures include modified major adverse cardiocerebral events (MACE), length of stay (LOS), and intensive care unit (ICU) stay...
August 19, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29158031/robot-assisted-renal-transplantation-using-the-retroperitoneal-approach-rart-with-more-than-one-year-follow-up-description-of-the-technique-and-results
#14
F Bruyère, B Pradère, B Faivre d'Arcier, J-M Boutin, M Buchler, N Brichart
OBJECTIVES: To describe the technique and report our first experience of robotic-assisted renal transplantation (RART) with more than one year follow up. PATIENTS AND METHODS: In our center the first case of RART was realized in October 2013 with a cadaveric graft. We used the combined extra- and intraperitoneal robot assisted laparoscopic route with extraperitoneal positioning of the graft and intraperitoneal transplantation. The patient was placed in the supine position with arms along the body; the robot came from the right inferior part of the patient...
November 17, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/29157923/outcomes-of-laparoscopic-and-open-surgery-in-children-with-and-without-congenital-heart-disease
#15
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/29157787/a-consultation-phone-service-for-patients-with-total-joint-arthroplasty-may-reduce-unnecessary-emergency-department-visits
#16
Eerik Hällfors, Sami A Saku, Tatu J Mäkinen, Rami Madanat
BACKGROUND: Different measures for reducing costs after total joint arthroplasty (TJA) have gained attention lately. At our institution, a free-of-charge consultation phone service was initiated that targeted patients with TJA. This service aimed at reducing unnecessary emergency department (ED) visits and, thus, potentially improving the cost-effectiveness of TJAs. To our knowledge, a similar consultation service had not been described previously. We aimed at examining the rates and reasons for early postdischarge phone calls and evaluating the efficacy of this consultation service...
October 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29157785/history-of-breast-cancer-increases-90-day-pulmonary-embolism-rates-and-reimbursements-after-total-hip-arthroplasty-a-national-matched-pair-analysis
#17
Samuel Rosas, Alejandro Marquez-Lara, Daniel N Bracey, Jennifer Kurowicki, Martin W Roche, Cynthia L Emory
BACKGROUND: Rates of total hip arthroplasty (THA) are projected to increase in the coming decades. Multiple studies have focused on identifying risk factors for adverse events after joint arthroplasty, and recent attention has been directed toward cancer. Very limited data have been published examining the effects of history of malignancy on outcomes after THA. With a concomitant increase in breast cancer diagnosis and treatments in recent years, it is expected that orthopedic surgeons will likely see more breast cancer survivors in clinic...
October 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29157759/effect-of-preoperative-education-on-postoperative-outcomes-among-patients-undergoing-cardiac-surgery-a-systematic-review-and-meta-analysis
#18
C Ramesh, Baby S Nayak, Vasudev Baburaya Pai, Nitin T Patil, Anice George, Linu Sara George, Elsa Sanatombi Devi
PURPOSE: The objective of this review was to assess the effect of preoperative education on postoperative outcomes among patients undergoing cardiac surgery. DESIGN: Systematic review and meta-analysis. METHODS: A comprehensive literature search was made on PubMed, CINAHL, Ovid, ProQuest, ScienceDirect, Scopus, Web of Science, and the Cochrane database between 1995 and 2015. Fourteen randomized controlled trials were included. Data analysis was performed with RevMan software and created the Supplementary Appendix using the GRADE approach...
December 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29157739/office-based-spirometry-a-new-model-of-care-in-preoperative-assessment-for-low-risk-lung-resections
#19
Jessica L Hudson, Jennifer M Bell, Traves D Crabtree, Daniel Kreisel, G Alexander Patterson, Bryan F Meyers, Varun Puri
BACKGROUND: Formal pulmonary function testing with laboratory spirometry (LS) is the standard of care for risk stratification before lung resection. LS and handheld office spirometry (OS) are clinically comparable for forced expiratory volume in 1 second and forced vital capacity. We investigated the safety of preoperative risk stratification based solely on OS. METHODS: Patients at low-risk for cardiopulmonary complications were enrolled in a single-center prospective study and underwent preoperative OS...
November 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29157682/outcomes-of-thoracic-endovascular-aortic-repair-for-chronic-aortic-dissections
#20
Allan M Conway, Khalil Qato, Laurie R Mondry, Guillaume J Stoffels, Gary Giangola, Alfio Carroccio
BACKGROUND: Open surgical repair remains the "gold standard" treatment for chronic type B aortic dissection (cTBD) with aneurysm. Thoracic endovascular aortic repair (TEVAR) has gained popularity in recent years for the treatment of thoracic aortic diseases, including cTBD. We assessed the effectiveness of TEVAR in the treatment of cTBD using the Vascular Quality Initiative (VQI) database. METHODS: The VQI registry identified 4713 patients treated with TEVAR from July 2010 to November 2015, including 125 repairs for cTBD...
November 17, 2017: Journal of Vascular Surgery
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