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Diabetic And hospital discharge

Mariano E Menendez, Sarah M Lawler, Jonathan Shaker, Nicole W Bassoff, Jon J P Warner, Andrew Jawa
BACKGROUND: As payment models shift toward a focus on value, an accurate understanding of surgical costs and preoperative correlates of high-cost patients is important for effective implementation of cost-saving strategies. This study used time-driven activity-based costing (TDABC) to explore inpatient cost of total shoulder arthroplasty (TSA) and to identify preoperative characteristics of high-cost patients. METHODS: Using TDABC, we calculated the cost of inpatient care for 415 patients undergoing elective primary TSA between 2016 and 2017...
December 5, 2018: Journal of Bone and Joint Surgery. American Volume
Yosefa Bar-Dayan, Julio Wainstein, Louis Schorr, Estela Derazne, Yehudith Schorr, Daniela Jakubowicz, Yonit Wohl
OBJECTIVE: To examine the association between hypoglycemic events and inpatient and outpatient mortality rates, and to characterize the profile of patients with diabetes who develop hypoglycemia during hospitalization in order to identify risk factors and potentially avoid it. RESEARCH DESIGN AND METHODS: This retrospective cohort study analyzed data of 3410 patients with diabetes hospitalized during 2012. The associations among biochemical measures, severity of hypoglycemia, inpatient length of stay, and mortality during hospitalization, one month and within one year after discharge were evaluated...
November 28, 2018: European Journal of Internal Medicine
Matthew M Fleming, Fangfang Liu, Jiajun Luo, Yawei Zhang, Kevin Y Pei
BACKGROUND: High-risk patients undergoing cholecystectomy may experience increased morbidity and mortality. Percutaneous cholecystostomy (PC) has been utilized as a treatment option for acute cholecystitis in this cohort. Little is known about risk factors for readmission following PC. MATERIALS AND METHODS: Patients who had PC from 2013 to 2014 were identified from the National Readmission Database by the Healthcare Cost and Utilization Project. A 30-d readmission was defined as a subsequent admission within 30 d following the first admission discharge date...
January 2019: Journal of Surgical Research
Amy Ahn, Kevin Phan, Zoe B Cheung, Samuel Jw White, Jun S Kim, Samuel K Cho
OBJECTIVE: To identify independent risk factors for non-home discharge in patients undergoing laminectomy for intradural extramedullary (IDEM) spinal tumors. METHODS: We performed a retrospective cohort analysis of data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) from 2011 to 2014. Adult patients undergoing laminectomy for the excision of IDEM spinal tumors were included and divided into 2 groups based on home or non-home discharge disposition...
November 27, 2018: World Neurosurgery
Jacob E Berman, Ana Mata-Fink, Hafiz F Kassam, Theodore A Blaine, David Kovacevic
INTRODUCTION: Identifying patient factors that affect length of stay (LOS) and discharge disposition after shoulder arthroplasty is key in managing patient expectations. In this systematic review, we identify patient-specific covariates that correlate with increased LOS and need for discharge to a facility. METHODS: We searched biomedical databases to identify associations between patient-specific factors and LOS and discharge disposition after shoulder arthroplasty...
November 28, 2018: Journal of the American Academy of Orthopaedic Surgeons
Mei-Ling Sharon Tai, Khean Jin Goh, Khairul Azmi Abdul Kadir, Mohd Idzwan Zakaria, Jun Fai Yap, Kay Sin Tan
INTRODUCTION: Intravenous (IV) thrombolysis with alteplase (rt-PA) is effective in ischaemic stroke. The primary objective was to evaluate predictors of functional outcome in acute ischaemic stroke (AIS) patients treated with IV rt-PA. The secondary objective was to assess the outcome with the modified Rankin scale (mRS). We also examined the predictive value of the Totaled Health Risks in Vascular Events (THRIVE) score. METHODS: AIS patients treated with IV rt-PA from February 2012 to August 2016 were recruited...
November 29, 2018: Singapore Medical Journal
Sayma Sabrina Khanam, Eunhee Choi, Jung-Woo Son, Jun-Won Lee, Young Jin Youn, Junghan Yoon, Seung-Hwan Lee, Jang-Young Kim, Sung Gyun Ahn, Min-Soo Ahn, Seok-Min Kang, Sang Hong Baek, Eun-Seok Jeon, Jae-Joong Kim, Myeong-Chan Cho, Shung Chull Chae, Byung-Hee Oh, Dong-Ju Choi, Byung-Su Yoo
BACKGROUND: In clinical practice, a risk prediction model is an effective solitary program to predict prognosis in particular patient groups. B-type natriuretic peptide (BNP)and N-terminal pro-b-type natriuretic peptide (NT-proBNP) are widely recognized outcome-predicting factors for patients with heart failure (HF).This study derived external validation of a risk score to predict 1-year mortality after discharge in hospitalized patients with HF using the Meta-analysis Global Group in Chronic Heart Failure (MAGGIC)program data...
2018: PloS One
Lindsey Blalock
INTRODUCTION: Current wound treatment options for complex wounds include advanced wound therapies. One such treatment, negative pressure wound therapy (NPWT), has evolved to include automated instillation of topical wound solutions with a user-specified dwell time (NPWTi-d). A novel reticulated open-cell foam dressing with through holes (ROCF-CC) was developed to assist wound cleansing by removing thick wound exudate and infectious material. OBJECTIVE: The author's experience using NPWTi-d with ROCF-CC on complex wounds is presented...
November 22, 2018: Wounds: a Compendium of Clinical Research and Practice
Ana V Pejčić, Slobodan M Janković, Goran Davidović
The objective of this study is to evaluate potential drug-drug interactions (pDDIs) and risk factors for pDDIs in three phases of an acute coronary syndrome (ACS) treatment: from the point of first medical contact to the coronary angiography (first phase), after coronary angiography to the last day of hospitalization (second phase), and at discharge from hospital (third phase). This retrospective observational cohort clinical study was conducted at the Clinic for Cardiology of the Clinical Centre Kragujevac, a public tertiary care hospital in Kragujevac, Serbia...
November 27, 2018: Internal and Emergency Medicine
Mohan Satish, Ryan W Walters, Venkata Mahesh Alla
PURPOSE: We sought to assess the trends in use, predictors of echocardiography, and its impact on in-hospital mortality in patients admitted with syncope using a large national database. METHODS: Utilizing the Nationwide Inpatient Sample (NIS) database from 2001 to 2014, we identified adult patients (>18 years) with a primary discharge diagnosis of syncope and use of echocardiogram was ascertained. RESULTS: A total of 3 174 619 patients with a primary discharge diagnosis of syncope were identified, of which 184 167 (5...
November 26, 2018: Echocardiography
Amanda Jayakody, Christopher Oldmeadow, Mariko Carey, Jamie Bryant, Tiffany Evans, Stephen Ella, John Attia, Rob Sanson-Fisher
BACKGROUND: Admitted patients with chronic disease are at high risk of an unplanned hospital readmission, however, little research has examined unplanned readmission among Aboriginal people in Australia. This study aimed to examine whether rates of unplanned 28 day hospital readmission, or death, significantly differ between Aboriginal and non-Aboriginal patients in New South Wales, Australia, over a nine-year period. METHODS: A retrospective cohort analysis of a sample of de-identified linked hospital administrative data was conducted...
November 26, 2018: BMC Health Services Research
Cem Emir Güldoğan, Murat Kendirci, Emre Gündoğdu, Ahmet Çınar Yastı
OBJECTIVE: Major burn injury is a type of trauma that still has high morbidity and mortality rates at all age groups. There is no consensus on the provided guidelines regarding the prediction of the severity of the victims. It is sometimes not easy to have sophisticated clinical and blood monitoring for developing countries. It is still a challenge for them. The aim of the present study was to analyze the factors that have an effect on mortality and serve as a guide for burn treatment...
November 20, 2018: Turkish Journal of Surgery
Lamiae Grimaldi-Bensouda, Lucien Abenhaim
The systematic case-referent method is a special case-referent design originally developed for pharmacoepidemiologic research purposes. It consists in the systematic collection of series of incident cases of various disorders and the assembling of a general reference pool, from which "controls" are secondarily selected to be matched to specific cases. Both series are collected independently from each other and with no a priori hypothesis to be investigated. The reference pool can be either general or limited to a subpopulation, representative of the source population of the cases...
October 26, 2018: Thérapie
Emily Styles, Renée S M Kidney, Caroline Carlin, Kevin Peterson
INTRODUCTION: Of more than 300,000 adult Minnesotans who have received a diagnosis of diabetes, 16% are younger than 45 years; however, state diabetes surveillance data primarily describe older adults. National reports suggest adults younger than 45 years are less likely than older adults with diabetes to meet blood glucose (hemoglobin A1c [HbA1c ]) goals. For this study on age-specific differences, we examined Minnesota data sets to determine if younger adults (ie, aged 18-44 y) are less likely to meet HbA1c goals and if hospitalization patterns differ from older adults (ie, aged 45-74 y) with diabetes...
November 21, 2018: Preventing Chronic Disease
Zain H Rizvi, Rocco Ferrandino, Quang Luu, Jeffrey D Suh, Marilene B Wang
BACKGROUND: Transsphenoidal pituitary surgery has evolved into a safe procedure with shorter hospitalizations, yet unplanned readmissions remain a quality measure for which there is a paucity of data. We sought to examine rates, timing, etiologic factors, and costs surrounding readmission after transsphenoidal pituitary surgery. METHODS: The Nationwide Readmissions Database (NRD) was queried for patients who underwent transsphenoidal pituitary between January 2013 and November 2013...
November 23, 2018: International Forum of Allergy & Rhinology
Toshikazu Abe, Hiroshi Ogura, Atsushi Shiraishi, Shigeki Kushimoto, Daizoh Saitoh, Seitaro Fujishima, Toshihiko Mayumi, Yasukazu Shiino, Taka-Aki Nakada, Takehiko Tarui, Toru Hifumi, Yasuhiro Otomo, Kohji Okamoto, Yutaka Umemura, Joji Kotani, Yuichiro Sakamoto, Junichi Sasaki, Shin-Ichiro Shiraishi, Kiyotsugu Takuma, Ryosuke Tsuruta, Akiyoshi Hagiwara, Kazuma Yamakawa, Tomohiko Masuno, Naoshi Takeyama, Norio Yamashita, Hiroto Ikeda, Masashi Ueyama, Satoshi Fujimi, Satoshi Gando
BACKGROUND: Sepsis is a leading cause of death and long-term disability in developed countries. A comprehensive report on the incidence, clinical characteristics, and evolving management of sepsis is important. Thus, this study aimed to evaluate the characteristics, management, and outcomes of patients with severe sepsis in Japan. METHODS: This is a cohort study of the Focused Outcomes Research in Emergency Care in Acute Respiratory Distress Syndrome, Sepsis, and Trauma (FORECAST) study, which was a multicenter, prospective cohort study conducted at 59 intensive care units (ICUs) from January 2016 to March 2017...
November 22, 2018: Critical Care: the Official Journal of the Critical Care Forum
Hongjiang Wu, Eric Sh Lau, Alice Ps Kong, Ronald Cw Ma, Risa Ozaki, Kitty Kt Cheung, Elaine Chow, Chiu Chi Tsang, Kam Piu Lau, Eric Mt Hui, Wing Yee So, Danijela Gasevic, Sarah H Wild, Juliana Cn Chan, Andrea Luk
Purpose: The aim of this study was to describe the association between educational level and incident cardiovascular disease (CVD) and all-cause mortality in Hong Kong Chinese patients with type 2 diabetes. Patients and methods: We included 12,634 patients with type 2 diabetes who were enrolled into the Joint Asia Diabetes Evaluation Program between June 1, 2007, and June 30, 2017. We classified patients' educational level into the following three groups: ≤6 years, 6-13 years, and >13 years...
2018: Clinical Epidemiology
Regev Cohen, Talya Finn, Frida Babushkin, Maurice Shapiro, Martina Uda, Tamar Grossman
BACKGROUND: We describe a patient with Strongyloides stercoralis hyperinfection associated with Streptococcus pyogenes and with streptococcal toxic shock syndrome. To the best of our knowledge this association has not been previously described. CASE PRESENTATION: A 78 year-old Israeli man, who was born in Iraq but lived in Israel for 66 years, presented with multi-organ failure including acute kidney and hepatic injury, coagulopathy, and lactic acidosis. He had a medical history including aortic valve replacement, diabetes mellitus, spinal stenosis, and low back pain treated with repeated local steroid injections...
November 22, 2018: Journal of Medical Case Reports
Katherine M French, Sasha Z Gonzalez, Scott E Sherman, Alissa R Link, Sadozai Zoe Malik, Chi-Hong Tseng, Saahil A Jumkhawala, Briesny Tejada, Andrew White, Joseph A Ladapo
BACKGROUND: Smoking is the leading preventable cause of death in the United States, but evidence-based smoking cessation therapy is underutilized. Financial incentive strategies represent an innovative approach for increasing the use of counseling and pharmacotherapy. If effective, they could supplement or supplant resource-intensive policy options, particularly in populations for whom smoking has substantial societal costs. FIESTA (Financial IncEntives for Smoking TreAtment) will randomize hospitalized smokers to receive usual smoking cessation care alone or usual smoking care augmented with financial incentives...
November 21, 2018: Trials
Dominika M Zoltowsk, Yashwant Agrawal, Nilesh Patel, Nishta Sareen, Jagadeesh K Kalavakunta, Vishal Gupta, Abdul Halabi
INTRODUCTION: This study was done to review the association of pulmonary hypertension (PH) with Transcatheter Aortic Valve Replacement (TAVR) procedures done in the US for years 2010 to 2012. METHODS: We used Nationwide Inpatient Sample (NIS) data to extract data for patients who were hospitalized with a primary/secondary diagnosis of TAVR as specified by International Classification of Disease (ICD-9) codes 35.05 and 35.06. PH was identified with ICD-9 codes 416...
November 19, 2018: Reviews on Recent Clinical Trials
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