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preadmission evaluation

Maurice Mars, Richard E Scott
INTRODUCTION: The smartphone simplifies interprofessional communication, and smartphone applications can facilitate telemedicine activity. Much has been written about the steps that need to be followed to implement and establish a successful telemedicine service that is integrated into everyday clinical practice. A traditional and systematic approach has evolved incorporating activities such as strategy development, needs assessment, business cases and plans, readiness assessment, implementation plans, change management interventions, and ongoing monitoring and evaluation...
March 29, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Inderpal Singh, Priya Fernando, Jane Griffin, Chris Edwards, Kathryn Williamson, Patrick Chance
BACKGROUND: Hospitals are currently admitting an increasing number of older people, and more than one-third could have an underlying mental health problem. The existing Older Adult Mental Health (OAMH) liaison service was increasingly unable to meet the escalating needs of older and frail patients. Therefore, the service was modernized and enhanced on an "invest-to-save" principle to provide a prompt holistic assessment for older adults with mental health problems. The objective of this study was a service evaluation to appraise clinical outcome, minimize the length of stay, and measure the predictors of adverse outcomes to streamline this enhanced service...
2017: Clinical Interventions in Aging
Erik C Madsen, Emily R Levy, Kate Madden, Anna A Agan, Ryan M Sullivan, Dionne A Graham, Adrienne G Randolph
OBJECTIVES: Low mannose-binding lectin levels and haplotypes associated with low mannose-binding lectin production have been associated with infection and severe sepsis. We tested the hypothesis that mannose-binding lectin levels would be associated with severe infection in a large cohort of critically ill children. DESIGN: Prospective cohort study. SETTING: Medical and Surgical PICUs, Boston Children's Hospital. PATIENTS: Children less than 21 years old admitted to the ICUs from November 2009 to November 2010...
February 2017: Pediatric Critical Care Medicine
Davide Ferorelli, Fiorenza Zotti, Silvio Tafuri, Angela Pezzolla, Alessandro Dell'Erba
The study aims to evaluate the use of Patient Safety Walkaround (SWR) execution model in an Italian Hospital, through the adoption of parametric indices, survey tools, and process indicators.In the 1st meeting an interview was conducted to verify the knowledge of concepts of clinical risk management (process indicators). One month after, the questions provided by Frankel (survey tool) were administered.Each month after, an SWR has been carried trying to assist the healthcare professionals and collecting suggestions and solutions...
October 2016: Medicine (Baltimore)
Sami Al Kasab, Rachael A Dawson, Jorge L Jaramillo, Jonathan J Halford
OBJECTIVE: The three important questions in video-EEG monitoring are (1) whether it is productive to monitor patients with low outpatient seizure frequency, (2) whether rapid down-titration of antiepileptic drugs (AEDs) during EMU admission helps generate more recorded seizures, and (3) how long a patient who has not yet had a seizure should be monitored in the EMU. This study aimed to answer these three questions. METHODS: Preadmission seizure frequency, times of AED administration, and times of seizure occurrence were collected on all adult patients admitted to the EMU at the Medical University of South Carolina (MUSC) between 2012 and 2014 - a total of 439 patients...
October 9, 2016: Epilepsy & Behavior: E&B
Jessica L Churchill, Kathleen E Puca, Elizabeth Meyer, Matthew Carleton, Michael J Anderson
Multiple studies have shown tranexamic acid (TXA) to reduce blood loss and transfusion rates in patients undergoing total knee arthroplasty (TKA). Accordingly, TXA has become a routine blood conservation agent for TKA. In contrast, ε-aminocaproic acid (EACA), a similar acting antifibrinolytic to TXA, has been less frequently used. This study evaluated whether EACA is as efficacious as TXA in reducing postoperative blood transfusion rates and compared the cost per surgery between agents. A multicenter retrospective chart review of elective unilateral TKA from April 2012 through December 2014 was performed...
October 3, 2016: Journal of Knee Surgery
Dermot P Maher, Pauline Woo, Waylan Wong, Xiao Zhang, Roya Yumul, Charles Louy
OBJECTIVE: To determine perioperative treatments and events associated with Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) responses among patients who undergo total hip arthroplasties (THAs) and total knee arthroplasties (TKAs). DESIGN: Retrospective analysis. SETTING: Single tertiary care, academic, urban, level 1 trauma center. PARTICIPANTS: Final cohort represents 301 consecutive surgical inpatients meeting criteria for evaluation by HCAHPS survey...
November 2016: Journal of Clinical Anesthesia
Michelle M Dowsey, Anthony Scott, Elizabeth A Nelson, Jinhu Li, Vijaya Sundararajan, Mandana Nikpour, Peter F M Choong
BACKGROUND: Osteoarthritis (OA) is a leading cause of disability in developed nations. Total knee arthroplasty (TKA) is a clinically effective treatment for people with end-stage knee OA, and represents one of the highest volume medical interventions globally. However, up to one in three patients remain dissatisfied following TKA. Research indicates that the strongest predictor of patient dissatisfaction following TKA is unmet expectations. This study will use a discrete choice experiment (DCE) provided to patients to improve knowledge of the expected outcomes of TKA...
2016: Trials
Wei Wei, Zhenxi Xia, Hongyan Gao, Jingjing Gong, Liping Yan, Yonghua Huang, Fei Chen, Weiwei Zhang
Although retinal and cerebral microvessels share similar embryological, anatomical and physiological characteristics, the correlation between retinopathy and leukoaraiosis (LA), a type of brain microvascular disease, is unclear. In the present study, the sample included 213 patients admitted to the department of neurology from January 2012 through October 2012. MRI and retinal photography were performed within 48hours of hospitalization, and patient demographics, comorbidities, preadmission medications and laboratory data were collected...
November 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Lonneke A van Vught, Brendon P Scicluna, Arie J Hoogendijk, Maryse A Wiewel, Peter M C Klein Klouwenberg, Olaf L Cremer, Janneke Horn, Peter Nürnberg, Marc M J Bonten, Marcus J Schultz, Tom van der Poll
BACKGROUND: Diabetes is associated with chronic inflammation and activation of the vascular endothelium and the coagulation system, which in a more acute manner are also observed in sepsis. Insulin and metformin exert immune modulatory effects. In this study, we aimed to determine the association of diabetes and preadmission insulin and metformin use with sepsis outcome and host response. METHODS: We evaluated 1104 patients with sepsis, admitted to the intensive care unit and stratified according to the presence or absence of diabetes mellitus...
August 6, 2016: Critical Care: the Official Journal of the Critical Care Forum
Barbara Haas, Hannah Wunsch
PURPOSE OF REVIEW: Critical illness has a significant impact on an individual's physical and mental health. However, it is less clear to what degree outcomes after critical illness are due to patients' preexisting characteristics, rather than the critical illness itself. In this review, we summarize recent findings regarding the role of age, comorbidity and frailty on long-term outcomes after critical illness. RECENT FINDINGS: Age, comorbidity and frailty are all associated with an increased risk of critical illness...
October 2016: Current Opinion in Critical Care
Katarzyna Krenke, Marta Krawiec, Grażyna Kraj, Joanna Peradzynska, Agnieszka Krauze, Marek Kulus
AIM: The aim of this study was to evaluate the factors that could predict the development of local complications (parapneumonic effusion/pleural empyema, necrotizing pneumonia, and lung abscess) in children with community-acquired pneumonia (CAP). METHODS: Demographic, clinical, and laboratory data were prospectively collected and compared in children with noncomplicated and complicated CAP. RESULTS: Two-hundred and three patients aged from 2 months to 17 years were enrolled...
July 12, 2016: Clinical Respiratory Journal
Chun-Ta Huang, Jou-Wei Lin, Sheng-Yuan Ruan, Chung-Yu Chen, Chong-Jen Yu
BACKGROUND/PURPOSE: Prolonged mechanical ventilation (PMV) is the most common situation where tracheostomy is indicated for intensive care unit (ICU) patients. However, it is unknown if this procedure confers survival benefits on PMV patients in a post-ICU setting. METHODS: Patients who were admitted to the specialized weaning unit from 2005 to 2008 and received PMV were included in this study. On admission, data pertaining to patient characteristics, physiologic status, and type of artificial airway (tracheostomy vs...
March 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
Justin K Scheer, Tamir T Ailon, Justin S Smith, Robert Hart, Douglas C Burton, Shay Bess, Brian J Neuman, Peter G Passias, Emily Miller, Christopher I Shaffrey, Frank Schwab, Virginie Lafage, Eric Klineberg, Christopher P Ames
INTRODUCTION: The length of stay (LOS) following adult spinal deformity (ASD) surgery is a critical time period allowing for recovery to levels safe enough to return home or to rehabilitation. Thus, the goal is to minimize it for conserving hospital resources and third-party payer pressure. Factors related to LOS have not been studied nor has a predictive model been created. The goal of this study was to construct a preadmission predictive model based on patients' baseline variables and modifiable surgical parameters...
August 2016: Neurosurgery
Jianfeng Liu, Jian Song, Di Zhao, Hui Li, Yingying Lu, Guobiao Wu, Kai Hou, Xuan Gao
BACKGROUND: Aneurysmal subarachnoid hemorrhage (aSAH) is a medical emergency with a high mortality and morbidity. There is a marked association of the ensuing neurological functional deficits following aSAH with the volume of hemorrhage. The volume of intracranial hemorrhage in aSAH is usually quantified by the revised Fisher grades. MATERIALS AND METHODS: A total of 155 patients who suffered from aSAH were evaluated for risk factors that led to an increased volume of intracranial hemorrhage...
July 2016: Neurology India
Bhaveen H Kapadia, Randa K Elmallah, Michael A Mont
BACKGROUND: Periprosthetic infections are devastating postoperative complications of total joint arthroplasty (TJA), with native skin flora commonly identified as causative organisms. We compared 2% chlorhexidine gluconate-impregnated cloths to standard-of-care antiseptic bathing in patients before TJA, to evaluate periprosthetic infection risk at 1-year follow-up. METHODS: This was a prospective, randomized, controlled trial at a single institution of patients undergoing hip or knee arthroplasty...
May 31, 2016: Journal of Arthroplasty
Pekka Vartiainen, Tarja Heiskanen, Harri Sintonen, Risto P Roine, Eija Kalso
Health-related quality of life (HRQoL) measurement aims to capture the complete, subjective health state of the patients and to comprehensively evaluate treatment outcomes. The aim of this study was to assess, using the 15D HRQoL instrument, HRQoL in a sample of 1528 chronic pain patients, referred to the multidisciplinary pain clinic of the Helsinki University Hospital during 2004 to 2012. The 15D results of the chronic pain patients were compared with those of a matched general population. To analyse the properties of the 15D, the results were compared with the preadmission questionnaire of the pain clinic, containing questions about background factors, aspects of the pain, and its impact on life...
October 2016: Pain
Yunis Mayasi, Johanna Helenius, Richard P Goddeau, Majaz Moonis, Nils Henninger
BACKGROUND: Delayed thrombolysis adversely impacts functional outcome after stroke. Therefore, great efforts are undertaken to reduce delay in patient presentation and initiate treatment as quickly as possible. However, little is known regarding the impact of time to presentation (TTP) on outcome in patients who are ineligible for acute stroke therapy. Thus, we sought to determine whether the TTP is associated with the 90-day outcome irrespective of eligibility for acute recanalization therapy...
October 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Caterina Romaniello, Erik Bertoletti, Nunzio Matera, Marina Farinelli, Vincenzo Pedone
BACKGROUND: The life expectancy of patients with disorders of consciousness (DOCs) is ever-increasing, but little is known about their clinical course over late stages. Several issues (premorbid conditions, complications and pressure sores) are to be considered for their effect on clinical outcome, risk of death and recovery of functional performance. Unfortunately, in late stages of long-term rehabilitation, these aspects are still more neglected than in acute and postacute stages. The aim of this study was to investigate the clinical course and the complications of patients in the late stages of DOCs and to explore the relationship between mortality and specific biomarkers...
June 2016: American Journal of the Medical Sciences
Deborah J Culley, Devon Flaherty, Srini Reddy, Margaret C Fahey, James Rudolph, Chuan Chin Huang, Xiaoxia Liu, Zhongcong Xie, Angela M Bader, Bradley T Hyman, Deborah Blacker, Gregory Crosby
BACKGROUND: Preexisting cognitive impairment is emerging as a predictor of poor postoperative outcomes in seniors. We hypothesized that preoperative cognitive screening can be performed in a busy preadmission evaluation center and that cognitive impairment is prevalent in elective geriatric surgical patients. METHODS: We approached 311 patients aged 65 years and older presenting for preoperative evaluation before elective surgery in a prospective, observational, single-center study...
July 2016: Anesthesia and Analgesia
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