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https://www.readbyqxmd.com/read/28435917/effect-of-employment-status-on-length-of-hospital-stay-30-day-readmission-and-patient-reported-outcomes-after-spine-surgery
#1
Owoicho Adogwa, Aladine A Elsamadicy, Jared Fialkoff, Ankit I Mehta, Raul A Vasquez, Joseph Cheng, Isaac O Karikari, Carlos A Bagley
BACKGROUND: Growing scrutiny has placed hospitals at the center of readmission prevention. The relationship between pre-operative employment status, length of hospital stays (LOS) and 30-day readmission rates after elective spine surgery remains unclear. METHODS: The medical records of 360 patients (employed: n=174, unemployed: n=70, retired: n=40, disabled: n=76) undergoing elective spine surgery at a major academic medical center were reviewed. Patient demographics, comorbidities, and post-operative complication rates were recorded...
March 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28435481/a-patient-centered-emergency-department-management-strategy-for-sickle-cell-disease-super-utilizers
#2
Grant G Simpson, Hallie R Hahn, Alex A Powel, Robert R Leverence, Linda A Morris, Lara G Thompson, Marc S Zumberg, Deepa J Borde, Joseph A Tyndall, Jonathan J Shuster, Donald M Yealy, Brandon R Allen
INTRODUCTION: A subpopulation of sickle-cell disease patients, termed super-utilizers, presents frequently to emergency departments (EDs) for vaso-occlusive events and may consume disproportionate resources without broader health benefit. To address the healthcare needs of this vulnerable patient population, we piloted a multidisciplinary intervention seeking to create and use individualized patient care plans that alter utilization through coordinated care. Our goals were to assess feasibility primarily, and to assess resource use secondarily...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28428892/a-comparison-of-earlier-and-enhanced-rehabilitation-of-mechanically-ventilated-patients-in-critical-care-compared-to-standard-care-rehab-study-protocol-for-a-single-site-randomised-controlled-feasibility-trial
#3
Catherine Snelson, Charlotte Jones, Gemma Atkins, James Hodson, Tony Whitehouse, Tonny Veenith, David Thickett, Emma Reeves, Aisling McLaughlin, Lauren Cooper, David McWilliams
BACKGROUND: Mortality from critical illness is improving, but survivors suffer from prolonged weakness and psychological and cognitive impairments. Maximising the recovery after critical illness has been highlighted as a research priority, especially in relation to an ageing population who present with higher rates of pre-morbid disability. Small studies have shown that starting rehabilitation early within the intensive care unit (ICU) improves short-term outcomes. Systematic reviews have highlighted the need for robust multicentre randomised controlled trials with longer term follow-up...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28424063/clinical-and-cost-effectiveness-analysis-of-early-detection-of-patients-at-nutrition-risk-during-their-hospital-stay-through-the-new-screening-method-cipa-a-study-protocol
#4
José Pablo Suárez-Llanos, Néstor Benítez-Brito, Laura Vallejo-Torres, Irina Delgado-Brito, Adriá Rosat-Rodrigo, Carolina Hernández-Carballo, Yolanda Ramallo-Fariña, Francisca Pereyra-García-Castro, Juan Carlos-Romero, Nieves Felipe-Pérez, Jennifer García-Niebla, Eduardo Mauricio Calderón-Ledezma, Teresa de Jesús González-Melián, Ignacio Llorente-Gómez de Segura, Manuel Ángel Barrera-Gómez
BACKGROUND: Malnutrition is highly prevalent in hospitalized patients and results in a worsened clinical course as well as an increased length of stay, mortality, and costs. Therefore, simple nutrition screening systems, such as CIPA (control of food intake, protein, anthropometry), may be implemented to facilitate the patient's recovery process. The aim of this study is to evaluate the effectiveness and cost-effectiveness of implementing such screening tool in a tertiary hospital, consistent with the lack of similar, published studies on any hospital nutrition screening system...
April 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28420281/long-term-follow-up-of-antithrombotic-management-patterns-in-patients-with-acute-coronary-syndrome-in-russia-an-observational-study-epicor-rus-study
#5
Mikhail Ya Ruda, Oleg V Averkov, Yunona V Khomitskaya
OBJECTIVE: This study sought to describe the short- and long-term (up to 2 years) antithrombotic management patterns in a real-life setting for patients hospitalized for an acute coronary syndrome (ACS) event, and to document clinical outcomes. RESEARCH DESIGN AND METHODS: EPICOR-RUS was a multicenter (34 centers), prospective, observational, longitudinal cohort study conducted across Russia on antithrombotic management in hospitalized (within 24 hours of symptom onset) ACS patients with 2 year follow-up...
April 19, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28419573/impella-2-5-initiated-prior-to-unprotected-left-main-pci-in-acute-myocardial-infarction-complicated-by-cardiogenic-shock-improves-early-survival
#6
Perwaiz M Meraj, Rajkumar Doshi, Theodore Schreiber, Brijeshwar Maini, William W O'Neill
OBJECTIVES: To assess post-procedural outcomes when Impella 2.5 percutaneous left ventricular assist device (pLVAD) support is initiated either prior to or after percutaneous coronary intervention (PCI) on unprotected left main coronary artery (ULMCA) culprit lesion in the context of acute myocardial infarction cardiogenic shock (AMICS). BACKGROUND: Initiation of Impella 2.5 pLVAD prior to PCI is associated with significant survival benefit in the setting of AMICS...
April 17, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28417897/oral-magnesium-supplementation-reduces-the-incidence-of-gastrointestinal-complications-following-cardiac-surgery-a-randomized-clinical-trial
#7
Seyed Tayeb Moradian, Mohammad Saeid Ghiasi, Alireza Mohamadpour, Yadollah Siavash
Gastrointestinal complications are common after coronary artery bypass graft surgery. These complications are ranged from nausea and vomiting to mesenteric ischemia and liver failure. It seems that nausea, vomiting, and constipation are related to magnesium deficiency. This study was designed to examine the effect of oral magnesium supplementation on the incidence of gastrointestinal complications in patients undergoing cardiac surgery. In a single blinded randomized clinical trial, 102 patients who were undergoing coronary artery bypass graft surgery were randomly allocated into two groups, 52 patients in the intervention and 50 patients in control group...
February 1, 2017: Magnesium Research: Official Organ of the International Society for the Development of Research on Magnesium
https://www.readbyqxmd.com/read/28416177/restoring-how-older-adults-manage-their-recovery-from-hip-fracture
#8
David J Healee, Antoinette McCallin, Marion Jones
AIMS AND OBJECTIVES: To generate a substantive theory that explained recovery from hip fracture from the perspective of older adults and find out how they managed it. BACKGROUND: Hip fracture is a well-researched phenomenon. The perspective of how older adults recover from hip fracture has been examined least of all. Patients spend less time in hospital following injury and generally recover in their home setting. DESIGN: A Glaserian grounded theory approach was used for this study...
March 9, 2017: International Journal of Orthopaedic and Trauma Nursing
https://www.readbyqxmd.com/read/28415881/hip-and-pelvic-fracture-patients-with-fear-of-falling-development-and-description-of-the-step-by-step-treatment-protocol
#9
Karin Kampe, Michaela Kohler, Diana Albrecht, Clemens Becker, Martin Hautzinger, Ulrich Lindemann, Klaus Pfeiffer
OBJECTIVE: Based on a theoretical framework and sound evidence, this article describes a rehabilitation programme for patients with fear of falling after hip and pelvic fracture. RATIONALE: Based on exercise science principles, current knowledge from fall prevention, emotion regulation, and the Health Action Process Approach we developed a theoretical framework, from which the components of the intervention were derived. Description of the intervention: The intervention consists of 6 components: (1) relaxation, (2) meaningful activities and mobility-based goals, (3) falls related cognitions and emotions, coping with high risk tasks and situations, (4) individual exercise programme, (5) planning and implementing exercises and activities, and (6) fall risks and hazards...
May 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28412943/generic-care-pathway-for-elderly-patients-in-need-of-home-care-services-after-discharge-from-hospital-a-cluster-randomised-controlled-trial
#10
Tove Røsstad, Øyvind Salvesen, Aslak Steinsbekk, Anders Grimsmo, Olav Sletvold, Helge Garåsen
BACKGROUND: Improved discharge arrangements and targeted post-discharge follow-up can reduce the risk of adverse events after hospital discharge for elderly patients. Although more care is to shift from specialist to primary care, there are few studies on post-discharge interventions run by primary care. A generic care pathway, Patient Trajectory for Home-dwelling elders (PaTH) including discharge arrangements and follow-up by primary care, was developed and introduced in Central Norway Region in 2009, applying checklists at defined stages in the patient trajectory...
April 17, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28412054/community-pharmacy-transition-of-care-services-and-rural-hospital-readmissions-a-case-study
#11
Allison P Patton, Yifei Liu, D Matthew Hartwig, Justin R May, Jessica Moon, Steven C Stoner, Kendall D Guthrie
OBJECTIVES: To explore community pharmacist involvement in the transition of care (TOC) process for patients discharged with acute myocardial infarction (AMI), heart failure (HF), pneumonia, chronic obstructive pulmonary disease (COPD), or elective total hip or knee arthroplasty (THA/TKA). SETTING: Patients discharged from a 60-bed acute care hospital located in rural Missouri were seen by a community pharmacist in 2 independent community pharmacy chain locations...
April 12, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28411287/impact-of-a-connected-care-model-on-30-day-readmission-rates-from-skilled-nursing-facilities
#12
Luke D Kim, Lei Kou, Bo Hu, Eiran Z Gorodeski, Michael B Rothberg
BACKGROUND: About one-fifth of hospitalized Medicare beneficiaries are discharged to skilled nursing facilities (SNFs) for post-acute care. Readmissions are common but interventions to reduce readmissions are scarce. OBJECTIVE: To assess the impact of a connected care model on 30-day hospital readmission rates among patients discharged to SNFs. DESIGN: Retrospective cohort. SETTING: SNFs that receive referrals from an academic medical center in Cleveland, Ohio...
April 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28409276/a-systematic-review-and-meta-analysis-of-the-post-operative-adverse-effects-associated-with-mosquito-net-mesh-in-comparison-to-commercial-hernia-mesh-for-inguinal-hernia-repair-in-low-income-countries
#13
REVIEW
T Patterson, P Currie, S Patterson, P Patterson, C Meek, R McMaster
PURPOSE: Abdominal wall hernia is a common surgical condition, with more than 20 million estimated to be repaired each year. Mesh repair is the standard for most repairs; however, the mesh material itself may be a barrier to care, the cost prohibitively high for some populations and healthcare systems. The aim of this systematic review and meta-analysis was to produce a pooled comparison between the adverse event rate associated with mosquito net mesh and commercial hernia mesh. METHODS: A systematic review was carried out in accordance with PRISMA guidelines...
April 13, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28409010/specialist-intervention-is-associated-with-improved-patient-outcomes-in-patients-with-decompensated-heart-failure-evaluation-of-the-impact-of-a-multidisciplinary-inpatient-heart-failure-team
#14
Jayne Masters, Geraint Morton, Isabel Anton, Jane Szymanski, Elizabeth Greenwood, Joanna Grogono, Andrew S Flett, John G F Cleland, Peter J Cowburn
OBJECTIVE: The study aimed to evaluate the impact of a multidisciplinary inpatient heart failure team (HFT) on treatment, hospital readmissions and mortality of patients with decompensated heart failure (HF). METHODS: A retrospective service evaluation was undertaken in a UK tertiary centre university hospital comparing 196 patients admitted with HF in the 6 months prior to the introduction of the HFT (pre-HFT) with all 211 patients seen by the HFT (post-HFT) during its first operational year...
2017: Open Heart
https://www.readbyqxmd.com/read/28409009/prognosis-of-complete-versus-incomplete-revascularisation-of-patients-with-stemi-with-multivessel-coronary-artery-disease-an-observational-study
#15
Aukelien C Dimitriu-Leen, Maaike P J Hermans, Caroline E Veltman, Bas L van der Hoeven, Alexander R van Rosendael, Erik W van Zwet, Martin J Schalij, Victoria Delgado, Jeroen J Bax, Arthur J H A Scholte
OBJECTIVE: The best strategy in patients with acute ST-segment elevation myocardial infarction (STEMI) with multivessel coronary artery disease (CAD) regarding completeness of revascularisation of the non-culprit lesion(s) is still unclear. To establish which strategy should be followed, survival rates over a longer period should be evaluated. The aim of this study was to investigate whether complete revascularisation, compared with incomplete revascularisation, is associated with reduced short-term and long-term all-cause mortality in patients with first STEMI and multivessel CAD...
2017: Open Heart
https://www.readbyqxmd.com/read/28404621/longitudinal-risk-of-adverse-events-in-patients-with-acute-kidney-injury-after-percutaneous-coronary-intervention-insights-from-the-national-cardiovascular-data-registry
#16
Javier A Valle, Lisa A McCoy, Thomas M Maddox, John S Rumsfeld, P Michael Ho, Ivan P Casserly, Brahmajee K Nallamothu, Matthew T Roe, Thomas T Tsai, John C Messenger
BACKGROUND: Acute kidney injury (AKI) remains a common complication after percutaneous coronary intervention (PCI) and is associated with adverse in-hospital patient outcomes. The incidence of adverse events after hospital discharge in patients having post-PCI AKI is poorly defined, and the relationship between AKI and outcomes after hospital discharge remains understudied. METHODS AND RESULTS: Using the National Cardiovascular Data Registry CathPCI registry, we assessed the incidence of AKI among Medicare beneficiaries after PCI from 2004 to 2009 and subsequent post-discharge adverse events at 1 year...
April 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28403899/hepato-bronchial-fistula-secondary-to-perforated-sigmoid-diverticulitis-a-case-report
#17
Jun Sunny Yin, Shaylan Govind, Daniele Wiseman, Richard Inculet, Raymond Kao
BACKGROUND: Patients with diverticulitis are predisposed to hepatic abscesses via seeding through the portal circulation. Hepatic abscesses are well-documented sequelae of diverticulitis, however instances of progression to hepato-bronchial fistulization are rare. We present a case of diverticulitis associated with hepatic abscess leading to hepato-bronchial fistulization, which represents a novel disease course not yet reported in the literature. CASE PRESENTATION: A 61-year-old Caucasian man presented with a history of unintentional weight loss and dyspnea both at rest and with exertion...
April 13, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28403508/impact-of-transitional-care-services-for-chronically-ill-older-patients-a-systematic-evidence-review
#18
Mélanie Le Berre, Geva Maimon, Nadia Sourial, Muriel Guériton, Isabelle Vedel
Transitions in care from hospital to primary care for older patients with chronic diseases (CD) are complex and lead to increased mortality and service use. In response to these challenges, transitional care (TC) interventions are being widely implemented. They encompass education on self-management, discharge planning, structured follow-up and coordination among the different healthcare professionals. We conducted a systematic review to determine the effectiveness of interventions targeting transitions from hospital to the primary care setting for chronically ill older patients...
April 12, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28403334/patient-safety-incidents-and-nursing-workload
#19
Katya Cuadros Carlesi, Kátia Grillo Padilha, Maria Cecília Toffoletto, Carlos Henriquez-Roldán, Monica Andrea Canales Juan
Objective: to identify the relationship between the workload of the nursing team and the occurrence of patient safety incidents linked to nursing care in a public hospital in Chile. Method: quantitative, analytical, cross-sectional research through review of medical records. The estimation of workload in Intensive Care Units (ICUs) was performed using the Therapeutic Interventions Scoring System (TISS-28) and for the other services, we used the nurse/patient and nursing assistant/patient ratios...
April 6, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/28392040/the-effect-of-guided-reflection-on-heart-failure-self-care-maintenance-and-management-a-mixed-methods-study
#20
Kristen A Sethares, Marilyn E Asselin
OBJECTIVE: Evaluate the effect of structured, guided reflection on patient descriptions of self-care maintenance and management. BACKGROUND: Inadequate HF self-care behaviors are linked to hospitalizations. Symptom monitoring and recognition are precursors to adequate HF self-care. Reflection on actions taken during HF exacerbations may lead to insights and future changes in HF self-care maintenance and management. METHODS: One-group mixed method pre-test/post-test design...
April 6, 2017: Heart & Lung: the Journal of Critical Care
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