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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/29160561/can-overnight-stenting-be-safely-eliminated-following-a-pharyngeal-flap-a-matched-comparison-study
#2
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
#3
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
#4
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
#5
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
#6
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/29159785/improving-the-hospital-quality-of-care-during-winter-periods-by-optimizing-budget-allocation-between-rotavirus-vaccination-and-bed-expansion
#7
Thibaut Dort, Nadia Schecroun, Baudouin Standaert
BACKGROUND: During each winter the hospital quality of care (QoC) in pediatric wards decreases due to a surge in pediatric infectious diseases leading to overcrowded units. Bed occupancy rates often surpass the good hospital bed management threshold of 85%, which can result in poor conditions in the workplace. This study explores how QoC-scores could be improved by investing in additional beds and/or better vaccination programs against vaccine-preventable infectious diseases. METHODS: The Cobb-Douglas model was selected to define the improvement in QoC (%) as a function of two strategies (rotavirus vaccination coverage [%] and addition of extra hospital beds [% of existing beds]), allowing improvement-isocurves to be produced...
November 20, 2017: Applied Health Economics and Health Policy
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
#8
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/29158075/intermediate-care-unit-after-cardiac-surgery-impact-on-length-of-stay-and-outcomes
#9
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
#10
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/29157923/outcomes-of-laparoscopic-and-open-surgery-in-children-with-and-without-congenital-heart-disease
#11
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/29157785/history-of-breast-cancer-increases-90-day-pulmonary-embolism-rates-and-reimbursements-after-total-hip-arthroplasty-a-national-matched-pair-analysis
#12
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/29157739/office-based-spirometry-a-new-model-of-care-in-preoperative-assessment-for-low-risk-lung-resections
#13
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
#14
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
https://www.readbyqxmd.com/read/29157373/risk-factors-affecting-length-of-stay-of-cats-in-an-animal-shelter-a-case-study-at-the-guelph-humane-society-2011-2016
#15
Natasha Janke, Olaf Berke, Tyler Flockhart, Shane Bateman, Jason B Coe
There is a strong need for animal shelters to determine strategies to decrease the incidence of healthy animals being euthanized due to a lack of space. Thus, the Capacity for Care program was implemented at the Guelph Humane Society during August 2014. One objective of the Capacity for Care program is to decrease length of stay of cats within the shelter to improve individual welfare and increase the number of successful adoptions. The current study uses data collected from the Guelph Humane Society between 2011 and 2016...
December 1, 2017: Preventive Veterinary Medicine
https://www.readbyqxmd.com/read/29157314/risk-factors-for-staphylococcus-aureus-acquisition-in-the-neonatal-intensive-care-unit-a-matched-case-case-control-study
#16
Matthew C Washam, Andrea Ankrum, Beth E Haberman, Mary Allen Staat, David B Haslam
OBJECTIVE To determine risk factors independent of length of stay (LOS) for Staphylococcus aureus acquisition in infants admitted to the neonatal intensive care unit (NICU). DESIGN Retrospective matched case-case-control study. SETTING Quaternary-care referral NICU at a large academic children's hospital. METHODS Infants admitted between January 2014 and March 2016 at a level IV NICU who acquired methicillin resistant (MRSA) or susceptible (MSSA) S. aureus were matched with controls by duration of exposure to determine risk factors for acquisition...
November 21, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29157041/relation-with-postpartum-maternal-morbidity-of-different-types-of-anesthesia-in-preeclamptic-patients
#17
Hasan Ulubaşoğlu, Kadir Bakay, Davut Güven
OBJECTIVE: The aim of this study is to investigate the effect of different anesthesia types administered to patients with preeclampsia on postoperative maternal morbidities. METHODS: Medical records of pregnant women complicated with preeclampsia delivered by cesarean from January 2010 to December 2016 in our clinic were retrospectively reviewed. RESULTS: There was not a statistically significant difference between patients receiving spinal anesthesia and general anesthesia in terms of additional parenteral analgesic requirement at postoperative period (p = 0...
November 20, 2017: Hypertension in Pregnancy
https://www.readbyqxmd.com/read/29157039/comparison-of-cesarean-versus-vaginal-delivery-of-extremely-preterm-gestations-in-breech-presentation-retrospective-cohort-study
#18
Kirsten M Niles, Jon F R Barrett, Noor Niyar N Ladhani
OBJECTIVE: As survival increases at earlier gestational ages, the optimal mode of delivery, especially in cases of breech presentation, is of increasing importance. The objective of this study was to compare outcomes of vaginal delivery (VD) and cesarean section (CS) births for infants in breech presentation at borderline viability. STUDY DESIGN: A retrospective chart review of live breech births between 23 + 0 and 25 + 6 weeks gestation at a tertiary university center from 2003 to 2013 was conducted...
November 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29155982/economic-and-survival-burden-of-dysphagia-among-inpatients-in-the-united-states
#19
D A Patel, S Krishnaswami, E Steger, E Conover, M F Vaezi, M R Ciucci, D O Francis
The inpatient burden of dysphagia has primarily been evaluated in patients with stroke. It is unclear whether dysphagia, irrespective of cause, is associated with worse clinical outcomes and higher costs compared to inpatients with similar demographic, hospital, and clinical characteristics without dysphagia. The aim of this study is to assess how a dysphagia diagnosis affects length of hospital stay (LOS), costs, discharge disposition, and in-hospital mortality among adult US inpatients. Annual and overall dysphagia prevalence, LOS, hospital charges, inpatient care costs, discharge disposition, and in-hospital mortality were measured using the AHRQ Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (2009-2013)...
November 16, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29155958/effect-of-preoperative-opioid-dosage-on-postoperative-period-after-thoracic-spinal-cord-stimulator-surgery
#20
Ravichandra A Madineni, Colin M Smith, Shannon W Clark, David W Boorman, Chengyuan Wu, Dajie Wang, James S Harrop, Ashwini D Sharan
Objective: We aim to study the impact of preoperative opioid dosage on postoperative length of stay (LOS) in patients undergoing thoracic spinal cord stimulator (SCS) placement surgery as a primary objective. Secondary objectives of this study include investigating patient-controlled analgesia (PCA) usage and postoperative complications like fever in relation to patients' preoperative opioid dosage and postoperative LOS. Methods: A total of 47 patients who underwent thoracic SCS for first time were retrospectively studied through chart review...
November 16, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
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