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https://www.readbyqxmd.com/read/28878047/long-term-risk-of-seizures-in-adult-survivors-of-sepsis
#1
Michael E Reznik, Alexander E Merkler, Ali Mahta, Santosh B Murthy, Jan Claassen, Hooman Kamel
OBJECTIVE: To examine the association between sepsis and the long-term risk of seizures. METHODS: We conducted a retrospective population-based cohort study using administrative claims data from all emergency department visits and hospitalizations at nonfederal acute care hospitals in California, Florida, and New York from 2005 to 2013. Using previously validated diagnosis codes, we identified all adult patients hospitalized with sepsis. Our outcome was any emergency department visit or hospitalization for seizure...
September 6, 2017: Neurology
https://www.readbyqxmd.com/read/28874949/sepsis-definitions-the-search-for-gold-and-what-cms-got-wrong
#2
REVIEW
Annahieta Kalantari, Haney Mallemat, Scott D Weingart
On October 1, 2015, the United States Centers for Medicare and Medicaid Services (CMS) issued a core measure addressing the care of septic patients. These core measures are controversial among healthcare providers. This article will address that there is no gold standard definition for sepsis, severe sepsis or septic shock and the CMS-assigned definitions for severe sepsis and septic shock are premature and inconsistent with evidence-based definitions.
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28858918/implementation-of-the-surviving-sepsis-campaign-guidelines
#3
Vikramjit Mukherjee, Laura Evans
PURPOSE OF REVIEW: Early identification and appropriate management of sepsis improves outcomes. Despite convincing data showing the benefits of early recognition and treatment of sepsis and septic shock, implementation of such evidence-based therapy is suboptimal. This review describes methods that have been shown to improve bedside application of the evidence-based guidelines. RECENT FINDINGS: The Surviving Sepsis Campaign (SSC) has developed guidelines for the management of severe sepsis and septic shock...
October 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28789803/preliminary-performance-on-the-new-cms-sepsis-1-national-quality-measure-early-insights-from-the-emergency-quality-network-e-qual
#4
Arjun K Venkatesh, Todd Slesinger, Jessica Whittle, Tiffany Osborn, Emily Aaronson, Craig Rothenberg, Nalani Tarrant, Pawan Goyal, Donald M Yealy, Jeremiah D Schuur
STUDY OBJECTIVE: We describe current hospital-level performance for the Centers for Medicare & Medicaid Services' Severe Sepsis/Septic Shock Early Management Bundle (SEP-1) quality measure and qualitatively assess emergency department (ED) sepsis quality improvement best practice implementation. METHODS: Using a standardized Web-based submission portal, we surveyed quality improvement data from volunteer hospital-based EDs participating in the Emergency Quality Network Sepsis Initiative...
August 5, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28759896/an-analysis-of-diagnoses-that-drive-readmission-what-can-we-learn-from-the-hospitals-in-southern-new-england-with-the-highest-and-lowest-readmission-performance
#5
Elizabeth M Goldberg, Blake Morphis, Rouba Youssef, Rebekah Gardner
Background: The Hospital Readmission Reduction Program was instituted by the Centers for Medicare & Medicaid Services in 2012 to incentivize hospitals to reduce readmissions. OBJECTIVE: To examine the most common diagnoses driving readmissions among fee-for-service Medicare beneficiaries in the hospitals with the highest and lowest readmission performance in Southern New England from 2014 to 2016. METHODS: This is a retrospective observational study using publicly available Hospital Compare data and Medicare Part A claims data...
August 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28689309/the-influence-of-gender-on-early-adverse-events-hospital-charges-and-length-of-stay-after-shoulder-arthroplasty
#6
Bryan M Saltzman, Bryce Basques, Timothy Leroux, Rachel M Frank, Gregory P Nicholson, Nikhil N Verma, Anthony A Romeo
PURPOSE: To identify differences in demographics, diagnosis, arthroplasty type, early adverse events, length of stay, and hospital costs between men and women undergoing shoulder arthroplasty. METHODS: We used a nationally representative U.S. population database to determine annual rates of shoulder arthroplasty (SA) in patients (2002-2011). Early adverse events, length-of-stay and hospitalization costs were determined, and compared between patient genders. RESULTS: A cohort of 372,753 patients underwent total-SA (TSA) (59...
July 9, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28666578/outpatient-beta-blockers-and-survival-from-sepsis-results-from-a-national-cohort-of-medicare-beneficiaries
#7
Kathleen E Singer, Courtney E Collins, Julie M Flahive, Allison S Wyman, M Didem Ayturk, Heena P Santry
BACKGROUND: Elderly Americans suffer increased mortality from sepsis. Given that beta-blockers have been shown to be cardioprotective in critical care, we investigated outpatient beta-blocker prescriptions and mortality among Medicare beneficiaries admitted for sepsis. METHODS: We queried a 5% random sample of Medicare beneficiaries for patients admitted with sepsis. We used in-hospital and outpatient prescription drug claims to compare in-hospital and 30-day mortality based on pre-admission beta-blocker prescription and class of beta-blocker prescribed using univariate tests of comparison and multivariable logistic regression models and another class of medications for control...
June 24, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28590946/hospitalization-among-individuals-waitlisted-for-kidney-transplant
#8
Kira L Newman, Raymond J Lynch, Andrew B Adams, Rebecca Zhang, Stephen O Pastan, Rachel E Patzer
BACKGROUND: For patients waitlisted for a deceased-donor kidney, hospitalization is associated with a lower likelihood of transplantation and worse posttransplant outcomes. However, individual-, neighborhood-, and regional-level risk factors for hospitalization throughout the waitlist period and specific causes of hospitalization in this population are unknown. METHODS: We used United States Renal Data System Medicare-linked data on patients waitlisted between 2005 and 2013 with continuous enrollment in Medicare Parts A & B (n=53 810) to examine the association between annual hospitalization rate and a variety of demographic, clinical, and social factors...
June 6, 2017: Transplantation
https://www.readbyqxmd.com/read/28550958/interprofessional-collaboration-to-improve-sepsis-care-and-survival-within-a-tertiary-care-emergency-department
#9
Elizabeth R Tedesco, Kimberly Whiteman, Melanie Heuston, Brenda Swanson-Biearman, Kimberly Stephens
PROBLEM: Sepsis is a leading cause of death in the United States; however, health care providers struggle with timely recognition, diagnosis, and treatment of patients. Both the Centers for Medicare and Medicaid Services and the National Quality Forum have identified this diagnosis as a priority. Presently, many patients with sepsis are identified late, resulting in significant morbidity and death. METHODS: In this project, a collaborative, interprofessional approach was created for screening and early identification of ED patients with possible sepsis...
May 25, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28514322/relationship-between-a-sepsis-intervention-bundle-and-in-hospital-mortality-among-hospitalized-patients-a-retrospective-analysis-of-real-world-data
#10
Priya A Prasad, Erica R Shea, Stephen Shiboski, Mary C Sullivan, Ralph Gonzales, David Shimabukuro
BACKGROUND: Sepsis is a systemic response to infection that can lead to tissue damage, organ failure, and death. Efforts have been made to develop evidence-based intervention bundles to identify and manage sepsis early in the course of the disease to decrease sepsis-related morbidity and mortality. We evaluated the relationship between a minimally invasive sepsis intervention bundle and in-hospital mortality using robust methods for observational data. METHODS: We performed a retrospective cohort study at the University of California, San Francisco, Medical Center among adult patients discharged between January 1, 2012, and December 31, 2014, and who received a diagnosis of severe sepsis/septic shock (SS/SS)...
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28507884/a-retrospective-analysis-of-complications-associated-with-bone-morphogenetic-protein-2-in-anterior-lumbar-interbody-fusion
#11
Kevork Hindoyan, Justin Tilan, Zorica Buser, Jeremiah R Cohen, Darrel S Brodke, Jim A Youssef, Jong-Beom Park, S Tim Yoon, Hans-Joerg Meisel, Jeffrey C Wang
STUDY DESIGN: Retrospective review. OBJECTIVE: The aim of our study was to quantify the frequency of complications associated with recombinant human bone morphogenetic protein 2 (rhBMP-2) use in anterior lumbar interbody fusion (ALIF). METHODS: The orthopedic subset of the Medicare database (PearlDiver) was queried for this retrospective cohort study using International Statistical Classification of Diseases 9 (ICD-9) and Current Procedure Terminology (CPT) codes for ALIF procedures with and without rhBMP-2 between 2005 and 2010...
April 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28477204/minimally-invasive-vs-open-nephrectomy-in-the-modern-era-does-approach-matter
#12
David M Golombos, Bilal Chughtai, Quoc-Dien Trinh, Dominique Thomas, Jialin Mao, Alexis Te, Padraic O'Malley, Douglas S Scherr, Joseph Del Pizzo, Jim C Hu, Art Sedrakyan
PURPOSE: To evaluate if the widespread adoption of a minimally invasive approach to radical nephrectomy has affected short- and long-term patient outcomes in the modern era. METHODS: A retrospective cohort study of patients who underwent radical nephrectomy from 2001 to 2012 was conducted using the US National Cancer Institute Surveillance Epidemiology and End Results (SEER) Program and Medicare insurance program database. Patients who underwent open surgery were compared to those who underwent minimally invasive surgery using propensity score matching...
May 5, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28471814/sepsis-associated-30-day-risk-standardized-readmissions-analysis-of-a-nationwide-medicare-sample
#13
Brett C Norman, Colin R Cooke, E Wes Ely, John A Graves
OBJECTIVES: To determine national readmission rates among sepsis survivors, variations in rates between hospitals, and determine whether measures of quality correlate with performance on sepsis readmissions. DESIGN: Cross-sectional study of sepsis readmissions between 2008 and 2011 in the Medicare fee-for-service database. SETTING: Acute care, Medicare participating hospitals from 2008 to 2011. PATIENTS: Septic patients as identified by International Classification of Diseases, Ninth Revision codes using the Angus method...
July 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28439131/compliance-with-updated-sepsis-bundles-to-meet-new-sepsis-core-measure-in-a-tertiary-care-hospital
#14
Taylor H Ramsdell, April N Smith, Eric Kerkhove
Background: The updated Surviving Sepsis Campaign care bundles are associated with improved outcomes in patients with sepsis, yet adherence to the bundles remains inconsistent. The Centers for Medicare & Medicaid Services has adopted similar care bundles as a core measure that went into effect with October 1, 2015 discharges. Objective: The aim of this study was to assess bundle compliance, length of stay (LOS), and in-hospital mortality before and after introduction of the new sepsis core measure. Methods: A retrospective cohort study was conducted in 158 patients with a diagnosis of severe sepsis or septic shock from April 2015 to February 2016...
March 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28320767/comparing-outcomes-between-antibody-induction-therapies-in-kidney-transplantation
#15
COMPARATIVE STUDY
Neel Koyawala, Jeffrey H Silber, Paul R Rosenbaum, Wei Wang, Alexander S Hill, Joseph G Reiter, Bijan A Niknam, Orit Even-Shoshan, Roy D Bloom, Deirdre Sawinski, Susanna Nazarian, Jennifer Trofe-Clark, Mary Ann Lim, Jesse D Schold, Peter P Reese
Kidney transplant recipients often receive antibody induction. Previous studies of induction therapy were often limited by short follow-up and/or absence of information about complications. After linking Organ Procurement and Transplantation Network data with Medicare claims, we compared outcomes between three induction therapies for kidney recipients. Using novel matching techniques developed on the basis of 15 clinical and demographic characteristics, we generated 1:1 pairs of alemtuzumab-rabbit antithymocyte globulin (rATG) (5330 pairs) and basiliximab-rATG (9378 pairs) recipients...
July 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28185753/predicting-the-incremental-hospital-cost-of-adverse-events-among-medicare-beneficiaries-in-the-comprehensive-joint-replacement-program-during-fiscal-year-2014
#16
Steven D Culler, David S Jevsevar, Kevin J McGuire, Kevin G Shea, Kenneth M Little, Michael J Schlosser
BACKGROUND: The Medicare program's Comprehensive Care for Joint Replacement (CJR) payment model places hospitals at financial risk for the treatment cost of Medicare beneficiaries (MBs) undergoing lower extremity joint replacement (LEJR). METHODS: This study uses Medicare Provider Analysis and Review File and identified 674,777 MBs with LEJR procedure during fiscal year 2014. Adverse events (death, acute myocardial infarction, pneumonia, sepsis or shock, surgical site bleeding, pulmonary embolism, mechanical complications, and periprosthetic joint infection) were studied...
January 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28178126/free-and-total-p-cresol-sulfate-levels-and-infectious-hospitalizations-in-hemodialysis-patients-in-choice-and-hemo
#17
RANDOMIZED CONTROLLED TRIAL
Tanushree Banerjee, Timothy W Meyer, Tariq Shafi, Thomas H Hostetter, Michal Melamed, Yunnuo Zhu, Neil R Powe
The uremic syndrome is attributed to progressive retention of compounds that, under normal conditions, are excreted by the healthy kidneys. p-cresol sulfate (PCS), a prototype protein-bound uremic retention solute, has been shown to exert toxic effects in vitro. Recent studies have identified relations between increased levels of PCS and indoxyl sulfate (IS) and adverse clinical outcomes in hemodialysis patients. We explored the relationship between free and total PCS and IS with infection-related hospitalizations (IH) and septicemia in 2 cohorts, Choices for Healthy Outcomes in Caring for end-stage renal disease (ESRD) Study (CHOICE) and Hemodialysis Study (HEMO)...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28153684/analysis-of-complication-rates-following-perioperative-transfusion-in-shoulder-arthroplasty
#18
A Jordan Grier, Abiram Bala, Colin T Penrose, Thorsten M Seyler, Michael P Bolognesi, Grant E Garrigues
BACKGROUND: Postoperative anemia requiring a blood transfusion is not uncommon following anatomic total shoulder arthroplasty (TSA) or reverse total shoulder arthroplasty (RTSA). However, the potential complications in patients undergoing transfusion after shoulder arthroplasty remain unclear. The goal of this study was to examine the postoperative outcomes of patients receiving blood transfusions following TSA and RTSA. METHODS: Using the Medicare Standard Analytic Files database, we identified all patients undergoing TSA or RTSA between 2005 and 2010...
July 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28027819/mortality-and-readmission-of-outcomes-after-discharge-from-the-surgical-intensive-care-unit-to-long-term-acute-care-hospitals
#19
Michelle C Nguyen, David S Strosberg, Teresa S Jones, Ankur Bhakta, Edward L Jones, Michael R Lyaker, Cindy A Byrd, Carly Sobol, Daniel S Eiferman
BACKGROUND: Patients with prolonged hospitalizations in the surgical intensive care unit often have ongoing medical needs that require further care at long-term, acute-care hospitals upon discharge. Setting expectations for patients and families after protracted operative intensive care unit hospitalization is challenging, and there are limited data to guide these conversations. The purpose of this study was to determine patient survival and readmission rates after discharge from the surgical intensive care unit directly to a long-term, acute-care hospital...
May 2017: Surgery
https://www.readbyqxmd.com/read/28017813/association-between-state-medical-malpractice-environment-and-postoperative-outcomes-in-the-united-states
#20
Christina A Minami, Catherine R Sheils, Emily Pavey, Jeanette W Chung, Jonah J Stulberg, David D Odell, Anthony D Yang, David J Bentrem, Karl Y Bilimoria
BACKGROUND: The US medical malpractice system assumes that the threat of liability should deter negligence, but it is unclear whether malpractice environment affects health care quality. We sought to explore the association between state malpractice environment and postoperative complication rates. STUDY DESIGN: This observational study included Medicare fee-for-service beneficiaries undergoing one of the following operations in 2010: colorectal, lung, esophageal, or pancreatic resection, total knee arthroplasty, craniotomy, gastric bypass, abdominal aortic aneurysm repair, coronary artery bypass grafting, or cystectomy...
March 2017: Journal of the American College of Surgeons
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