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preadmission evaluation

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https://www.readbyqxmd.com/read/29750681/predischarge-and-postdischarge-risk-factors-for-hospital-readmission-among-patients-with-diabetes
#1
Abhijana Karunakaran, Huaqing Zhao, Daniel J Rubin
BACKGROUND: Hospital readmission within 30 days of discharge (30-d readmission) is an undesirable outcome. Readmission of patients with diabetes is common and costly. Most of the studies that have examined readmission risk factors among diabetes patients did not include potentially important clinical data. OBJECTIVES: To provide a more comprehensive understanding of 30-day readmission risk factors among patients with diabetes based on predischarge and postdischarge data...
May 10, 2018: Medical Care
https://www.readbyqxmd.com/read/29742757/evaluation-of-a-novel-system-to-enhance-clinicians-recognition-of-preadmission-adverse-drug-reactions
#2
Joshua C Smith, Qingxia Chen, Joshua C Denny, Dan M Roden, Kevin B Johnson, Randolph A Miller
BACKGROUND:  Often unrecognized by providers, adverse drug reactions (ADRs) diminish patients' quality of life, cause preventable admissions and emergency department visits, and increase health care costs. OBJECTIVE:  This article evaluates whether an automated system, the Adverse Drug Effect Recognizer (ADER), could assist clinicians in detecting and addressing inpatients' ongoing preadmission ADRs. METHODS:  ADER uses natural language processing to extract patients' medications, findings, and past diagnoses from admission notes...
April 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29685699/the-crac-cohort-model-a-computerized-low-cost-registry-of-interventional-cardiology-with-daily-update-and-long-term-follow-up
#3
G Rangé, S Chassaing, P Marcollet, C Saint-Étienne, P Dequenne, M Goralski, P Bardiére, F Beverilli, L Godillon, B Sabine, C Laure, S Gautier, R Hakim, F Albert, D Angoulvant, L Grammatico-Guillon
OBJECTIVES: To assess the reliability and low cost of a computerized interventional cardiology (IC) registry to prospectively and systematically collect high-quality data for all consecutive coronary patients referred for coronary angiogram or/and coronary angioplasty. BACKGROUND: Rigorous clinical practice assessment is a key factor to improve prognosis in IC. A prospective and permanent registry could achieve this goal but, presumably, at high cost and low level of data quality...
April 20, 2018: Revue D'épidémiologie et de Santé Publique
https://www.readbyqxmd.com/read/29649027/pain-and-its-long-term-interference-of-daily-life-after-critical-illness
#4
Christina J Hayhurst, Jim C Jackson, Kristin R Archer, Jennifer L Thompson, Rameela Chandrasekhar, Christopher G Hughes
BACKGROUND: Persistent pain likely interferes with quality of life in survivors of critical illness, but data are limited on its prevalence and risk factors. We sought to determine the prevalence of persistent pain after critical illness and its interference with daily life. Additionally, we sought to determine if intensive care unit (ICU) opioid exposure is a risk factor for its development. METHODS: In a cohort of adult medical and surgical ICU survivors, we used the brief pain inventory (BPI) to assess pain intensity and pain interference of daily life at 3 and 12 months after hospital discharge...
April 11, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29555496/effect-of-an-e-learning-tool-on-expectations-and-satisfaction-following-total-knee-arthroplasty-a-randomized-controlled-trial
#5
Sharon E Culliton, Dianne M Bryant, Steven J MacDonald, Kathy M Hibbert, Bert M Chesworth
BACKGROUND: Orthopedic surgeons recognize patient expectations of total knee arthroplasty (TKA) can be managed through education. E-learning is the application of educational technology. The objective of this study was to evaluate whether an e-learning tool could affect whether patients' expectations were met and they were satisfied 1 year following TKA. METHODS: Patients with osteoarthritis from the London Health Sciences Centre, Canada, were randomly assigned to either a control group (n = 207) receiving standard patient education or an intervention group (n = 209) using the e-learning tool in addition to the standard...
February 17, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29407089/basal-functional-status-predicts-one-year-mortality-after-a-heart-failure-hospitalization-in-elderly-patients-the-rica-prospective-study
#6
David Chivite, Francesc Formiga, Xavier Corbella, Alicia Conde-Martel, Óscar Aramburu, Margarita Carrera, Melitón Francisco Dávila, José Pérez-Silvestre, Luis Manzano, Manuel Montero-Pérez-Barquero
BACKGROUND: Dependence for basic activities of the daily living (ADL) relates to adverse outcomes in elderly acute heart failure (AHF) patients. METHODS: We evaluated patients ≥75years admitted because of AHF, divided according to preadmission Barthel Index (BI) category: severe (BI 0-60), moderate (BI 61-90) and slight dependence or independence for basic ADL (BI 91-100). We compared their baseline characteristics and used logistic regression models to determine whether a BI≤60 confers higher one-year mortality risk...
March 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29379965/association-between-undergraduate-performance-predictors-and-academic-and-clinical-performance-of-osteopathic-medical-students
#7
Farshad Agahi, Mark R Speicher, Grace Cisek
Context: Medical schools use a variety of preadmission indices to select potential students. These indices generally include undergraduate grade point average (GPA), Medical College Admission Test (MCAT) scores, and preadmission interviews. Objective: To investigate whether the admission indices used by Midwestern University Arizona College of Osteopathic Medicine are associated with the academic and clinical performance of their students. Methods: Associations between the prematriculation variables of undergraduate science GPA, undergraduate total GPA, MCAT component scores, and interview scores and the academic and clinical variables of the first- and second-year medical school GPA, Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) Level 1 and Level 2-Cognitive Evaluation (CE) total and discipline scores, scores in clinical rotations for osteopathic competencies, COMLEX-USA Level 2-Performance Evaluation passage, and match status were evaluated...
February 1, 2018: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/29355958/canine-pancreatic-lipase-immunoreactivity-concentrations-associated-with-intervertebral-disc-disease-in-84-dogs
#8
R O Schueler, G White, R L Schueler, J M Steiner, A Wassef
OBJECTIVE: To determine the differences in serum canine pancreatic lipase immunoreactivity between dogs with intervertebral disc herniation and healthy control dogs. MATERIALS AND METHODS: Eighty-four client-owned dogs with intervertebral disc herniation, diagnosed by neurologic examination and imaging, and 18 healthy control dogs. Samples of whole blood were collected within 90 minutes of admission. Serum canine pancreatic lipase immunoreactivity concentrations were measured by a commercial immunoassay and evaluated for association with intervertebral disc herniation, signalment, neurolocalisation and the preadmission administration of glucocorticosteriods or non-steroidal anti-inflammatory drugs...
May 2018: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29240853/the-evaluation-of-medical-inpatients-who-are-admitted-on-long-term-opioid-therapy-for-chronic-pain
#9
Hilary Mosher, Shoshana J Herzig, Itai Danovitch, Christina Boutsicaris, Sameer Hassamal, Karl Wittnebel, Azadeh Dashti, Teryl Nuckols
Individuals who are on long-term opioid therapy (LTOT) for chronic noncancer pain are frequently admitted to the hospital with acute pain, exacerbations of chronic pain, or comorbidities. Consequently, hospitalists find themselves faced with complex treatment decisions in the context of uncertainty about the effectiveness of LTOT as well as concerns about risks of overdose, opioid use disorders, and adverse events. Our multidisciplinary team sought to synthesize guideline recommendations and primary literature relevant to assessing medical inpatients on LTOT, with the objective of assisting practitioners in balancing effective pain treatment and opioid risk reduction...
December 6, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29193694/association-between-diabetes-and-mortality-in-elderly-patients-admitted-for-a-first-episode-of-acute-heart-failure
#10
Francesc Formiga, David Chivite, Abelardo Montero, Irene Petit, Rafael Moreno-González, Jonathan Franco, Xavier Corbella
AIM: To examine whether the presence of a prior diagnosis of diabetes mellitus (DM) influences mortality risk in elderly patients experiencing a first episode of heart failure (HF) hospitalization. METHODS: A total of 677 consecutive patients aged ≥75 years admitted for a first episode of acute decompensated heart failure were evaluated according to the presence or not of DM, and in-hospital and 1-year mortality rates were evaluated. RESULTS: A total of 240 patients (35...
November 28, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29070714/statins-and-the-risk-of-intracerebral-hemorrhage-in-patients-with-previous-ischemic-stroke-or-transient-ischemic-attack
#11
David Gaist, Larry B Goldstein, Lucía Cea Soriano, Luis Alberto García Rodríguez
BACKGROUND AND PURPOSE: Although there is no overall association between statin use and intracerebral hemorrhage (ICH), whether there is an increased risk among those with a history of ischemic stroke (IS) or transient ischemic attack (TIA) remains controversial. We evaluated the relationship of preadmission statin use with the risk of ICH in patients with a history of IS or TIA in a population-based cohort. METHODS: The Health Improvement Network primary care database in the United Kingdom was used to identify new users of low-dose aspirin and a matched comparison...
December 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29045274/recruiting-american-indian-alaska-native-students-to-medical-school-a-multi-institutional-alliance-in-the-u-s-southwest
#12
Marlene P Ballejos, Polly Olsen, Tanisha Price-Johnson, Cindy Garcia, Tassy Parker, Robert E Sapién, Valerie Romero-Leggott
PROBLEM: Despite national efforts to diversify the physician workforce, American Indian/Alaska Native (AI/AN) individuals have the least representation of all major racial and ethnic groups. Limited resources at state medical schools present institution-level recruitment challenges. Unified efforts to engage AI/AN students in premedical education activities are needed. APPROACH: The medical schools at the Universities of Arizona (Phoenix and Tucson), Colorado, New Mexico, and Utah identified a collective need to increase student diversity, particularly with regard to AI/AN students...
January 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29031498/low-free-triiodothyronine-at-admission-predicts-poststroke-infection
#13
Satoshi Suda, Junya Aoki, Takashi Shimoyama, Kentaro Suzuki, Yuki Sakamoto, Takehiro Katano, Seiji Okubo, Chikako Nito, Yasuhiro Nishiyama, Masahiro Mishina, Kazumi Kimura
BACKGROUND: Poststroke infection (PSI) is common and is usually associated with a severe prognosis. We investigated the association between PSI and thyroid hormones, which are critical to immune regulation, in patients with acute stroke. METHODS: We retrospectively enrolled 520 consecutive patients with acute ischemic stroke (326 men; age, 71.9 ± 13.2 years) admitted to our department between September 2014 and June 2016. The impact of serum thyroid hormone levels measured at admission (thyroid-stimulating hormone [TSH], free triiodothyronine [FT3], and free thyroxine [FT4]) on the PSI was evaluated using multivariate logistic regression analysis...
February 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29017792/three-dimensional-printing-of-navigational-template-in-localization-of-pulmonary-nodule-a-pilot-study
#14
Lei Zhang, Mu Li, Zeyao Li, Xiermaimaiti Kedeer, Long Wang, Ziwen Fan, Chang Chen
BACKGROUND: Small pulmonary nodules are a common problem, especially with the wide implementation of lung cancer-screening program. This poses a great challenge to thoracic surgeons because of the difficulty of nodule localization. We recently built an efficient, customized navigational template using 3-dimensional (3D) printing technology to facilitate the procedure of lung nodule localization. This study aims to investigate its feasibility in clinical application. METHODS: Patients with peripheral lung nodules (<2 cm) were enrolled...
September 1, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28860348/assessment-of-sepsis-3-criteria-and-quick-sofa-in-patients-with-cirrhosis-and-bacterial-infections
#15
Salvatore Piano, Michele Bartoletti, Marta Tonon, Maurizio Baldassarre, Giada Chies, Antonietta Romano, Pierluigi Viale, Elia Vettore, Marco Domenicali, Marialuisa Stanco, Chiara Pilutti, Anna Chiara Frigo, Alessandra Brocca, Mauro Bernardi, Paolo Caraceni, Paolo Angeli
INTRODUCTION: Patients with cirrhosis have a high risk of sepsis, which confers a poor prognosis. The systemic inflammatory response syndrome (SIRS) criteria have several limitations in cirrhosis. Recently, new criteria for sepsis (Sepsis-3) have been suggested in the general population (increase of Sequential Organ Failure Assessment (SOFA) ≥2 points from baseline). Outside the intensive care unit (ICU), the quick SOFA (qSOFA (at least two among alteration in mental status, systolic blood pressure ≤100 mm Hg or respiratory rate ≥22/min)) was suggested to screen for sepsis...
August 31, 2017: Gut
https://www.readbyqxmd.com/read/28761004/multicenter-observational-study-of-the-use-of-nebulized-hypertonic-saline-to-treat-children-hospitalized-for-bronchiolitis-from-2008-to-2014
#16
Joshua Davis, Amy D Thompson, Jonathan M Mansbach, Pedro A Piedra, Kohei Kasagawa, Ashley F Sullivan, Janice A Espinola, Carlos A Camargo
OBJECTIVES: Among children hospitalized for bronchiolitis, we examined temporal trends in the use of hypertonic saline (HTS) and the characteristics associated with receiving this treatment. METHODS: We conducted a secondary analysis of data from 2 large, multicenter prospective cohort studies that included young children hospitalized with bronchiolitis during 5 winter seasons (2008-2014). Our outcome was receipt of HTS any time during the preadmission visit or hospitalization...
July 31, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28707992/transitional-care-services-a-quality-and-safety-process-improvement-program-in-neurosurgery
#17
Faith C Robertson, Jessica L Logsdon, Hormuzdiyar H Dasenbrock, Sandra C Yan, Siobhan M Raftery, Timothy R Smith, William B Gormley
OBJECTIVE Readmissions increasingly serve as a metric of hospital performance, inviting quality improvement initiatives in both medicine and surgery. However, few readmission reduction programs have targeted surgical patient populations. The objective of this study was to establish a transitional care program (TCP) with the goal of decreasing length of stay (LOS), improving discharge efficiency, and reducing readmissions of neurosurgical patients by optimizing patient education and postdischarge surveillance...
July 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28644310/predictors-of-mortality-in-cirrhosis-inpatients-with-clostridium-difficile-infection
#18
Elliot Z Smith, Patrick G Northup, Curtis K Argo
BACKGROUND: Clostridium difficile is a bacterial pathogen associated with significant morbidity and mortality in patients with cirrhosis. GOALS: Our primary aim is to identify variables that are predictive of poor outcomes in cirrhosis patients with C. difficile infection (CDI). We also aim to further characterize the risk factors for developing CDI and risk of mortality in this patient population. STUDY: A total of 200 subjects with a diagnosis of cirrhosis and CDI were matched to 200 cirrhosis inpatients without CDI...
June 21, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28628498/earlier-physical-therapy-input-is-associated-with-a-reduced-length-of-hospital-stay-and-reduced-care-needs-on-discharge-in-frail-older-inpatients-an-observational-study
#19
Peter J Hartley, Victoria L Keevil, Ledia Alushi, Rebecca L Charles, Eimear B Conroy, Patricia M Costello, Becki Dixon, Aida M Dolinska-Grzybek, Diana Vajda, Roman Romero-Ortuno
BACKGROUND AND PURPOSE: Pressures on hospital bed occupancy in the English National Health Service have focused attention on enhanced service delivery models and methods by which physical therapists might contribute to effective cost savings, while retaining a patient-centered approach. Earlier access to physical therapy may lead to better outcomes in frail older inpatients, but this has not been well studied in acute National Health Service hospitals. Our aim was to retrospectively study the associations between early physical therapy input and length of hospital stay (LOS), functional outcomes, and care needs on discharge...
June 16, 2017: Journal of Geriatric Physical Therapy
https://www.readbyqxmd.com/read/28507597/low-adherence-to-national-guidelines-for-proton-pump-inhibitor-prescription-in-patients-receiving-combination-aspirin-and-anticoagulation
#20
Rajani Sharma, Abhik Roy, Christopher Ramos, Richard Rosenberg, Reuben Garcia-Carrasquillo, Benjamin Lebwohl
BACKGROUND: Aspirin, when used with concurrent anticoagulation, increases the risk of gastrointestinal bleeding (GIB). Therefore, multisociety guidelines recommend prophylactic proton-pump inhibitors (PPIs) for patients receiving aspirin and anticoagulation. We aimed to determine rates and predictors of adherence to these recommendations. METHODS: All adult inpatients discharged from the hospital on aspirin and anticoagulation from July 2009 to June 2014 were retrospectively evaluated for PPI prescription on discharge instructions...
May 2017: Therapeutic Advances in Gastroenterology
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