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https://www.readbyqxmd.com/read/29155982/economic-and-survival-burden-of-dysphagia-among-inpatients-in-the-united-states
#1
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/29153427/does-a-mobile-ecls-program-reduce-mortality-for-patients-transported-for-ecls-therapy-for-severe-acute-respiratory-failure
#2
Jacob T Gutsche, Todd A Miano, William Vernick, Jesse Raiten, Christian Bermudez, Prashant Vallabjoysula, Karianna Milewski, Wilson Szeto, Meghan Lane Fall, Matthew L Williams, Prakash Patel, Mark E Mikkelsen, Cornel Chiu, Harish Ramakrishna, Jeremy Canon, John G Augoustides
OBJECTIVE: To understand if mobile extracorporeal membrane oxygenation reduces patient mortality during and after transport of patients requiring extracorporeal membrane oxygenation for acute respiratory distress syndrome. DESIGN: Retrospective chart review. SETTING: University affiliated tertiary care hospitals. PARTICIPANTS: Seventy-seven patients. INTERVENTIONS: Introduction of a mobile extracorporeal membrane oxygenation (ECMO) program designed to facilitate the implementation of ECMO at outside hospitals in patients too unstable for transport for ECMO...
September 2, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29153396/the-prognostic-value-of-serum-uric-acid-in-the-acute-phase-of-ischemic-stroke-in-black-africans
#3
Yacouba Njankouo Mapoure, Chia Mark Ayeah, Hamadou Ba, Romuald Hentchoya, Henry Namme Luma
BACKGROUND: The association between hyperuricemia and stroke outcome still remains controversial worldwide. This study aims to determine the prevalence of hyperuricemia and its association with the outcome of patients with acute ischemic stroke in a tertiary care hospital. METHODS: This was a hospital-based prospective cohort study that included patients with ischemic stroke with baseline uric acid levels and 3-month post-stroke follow-up data. Associations between hyperuricemia and stroke outcomes were analyzed using multiple logistic regression, Kaplan-Meier, and Cox proportional hazards regression analysis...
November 15, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29153252/antimicrobial-stewardship-in-pediatric-post-acute-care-facilities
#4
Candace L Johnson, Meaghan Jain, Lisa Saiman, Natalie Neu
Providers in pediatric post-acute care facilities were surveyed about knowledge of and resources for antimicrobial stewardship. All agreed that antibiotics were overused in such pediatric facilities, but 60% had not implemented stewardship strategies. Lack of treatment guidelines (47%) was identified as the most common barrier to antimicrobial stewardship.
November 15, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29152607/use-of-post-acute-care-after-hospital-discharge-in-urban-and-rural-hospitals
#5
Robert E Burke, Christine D Jones, Eric A Coleman, Jason R Falvey, Jennifer E Stevens-Lapsley, Adit A Ginde
Objectives: Geographic variation in the use of post-acute care (PAC - skilled nursing facility and home health care) after hospital discharge is substantial, but reasons for this remain largely unexplored. PAC use in urban hospitals compared to rural hospitals may be one key contributor. We aimed to describe PAC use, explore substitution of one type of PAC for another, and identify how PAC use varies by diagnosis in urban and rural settings. Study Design: Secondary analysis of the 2012 National Inpatient Sample including adult discharges to PAC after a hospitalization...
March 2017: Am J Accountable Care
https://www.readbyqxmd.com/read/29149389/autoregulation-in-paediatric-tbi-current-evidence-and-implications-for-treatment
#6
REVIEW
Joseph E Donnelly, Adam M H Young, Ken Brady
BACKGROUND: Children who survive acute traumatic brain injury are at risk of death from subsequent brain swelling and secondary injury. Strict physiologic management in the ICU after traumatic brain injury is believed to be key to survival, and cerebral perfusion pressure is a prominent aspect of post brain injury care. However, optimal cerebral perfusion pressure targets for children are not known. Autoregulation monitoring has been used to delineate individualized optimal perfusion pressures for patients with traumatic brain injury...
October 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29149019/incidence-and-consequences-of-near-drowning-related-pneumonia-a-descriptive-series-from-martinique-french-west-indies
#7
Laura Cerland, Bruno Mégarbane, Hatem Kallel, Yanick Brouste, Hossein Mehdaoui, Dabor Resiere
Drowning represents one major cause of accidental death. Near-drowning patients are exposed to aspiration that may result in pneumonia with life-threatening consequences. We designed this descriptive study to investigate the frequency, nature, and consequences of post-drowning pneumonia. One hundred and forty-four near-drowning patients (33 children and 111 adults) admitted during four years to the University Hospital of Martinique, French Indies, were included. Patients presented pre-hospital cardiac arrest (41%) and exhibited acute respiratory failure (54%), cardiovascular failure (27%), and lactic acidosis (75%) on admission...
November 17, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29148338/comprehensive-support-for-family-caregivers-impact-on-veteran-health-care-utilization-and-costs
#8
Courtney Harold Van Houtven, Valerie A Smith, Karen M Stechuchak, Megan Shepherd-Banigan, Susan Nicole Hastings, Matthew L Maciejewski, Gilbert Darryl Wieland, Maren K Olsen, Katherine E M Miller, Margaret Kabat, Jennifer Henius, Margaret Campbell-Kotler, Eugene Z Oddone
This study aimed to examine the early impact of the Program of Comprehensive Assistance for Family Caregivers (PCAFC) on Veteran health care utilization and costs. A pre-post cohort design including a nonequivalent control group was used to understand how Veterans' use of Veteran Affairs health care and total health care costs changed in 6-month intervals up to 3 years after PCAFC enrollment. The control group was an inverse probability of treatment weighted sample of Veterans whose caregivers applied for, but were not accepted into, PCAFC...
March 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29146420/extracorporeal-membrane-oxygenation-used-successfully-in-a-near-fatal-case-of-opioid-induced-acute-respiratory-distress-syndrome
#9
Karen Greenberg, Benjamin Kohl
Acute Respiratory Distress Syndrome (ARDS) was first recognized during the 1960s. It is a distinct type of hypoxemic respiratory failure characterized by acute abnormality of both lungs. Extracorporeal membrane oxygenation (ECMO) is being increasingly used for patients with severe ARDS refractory to otherwise conventional management. A 29year old male arrived with Emergency Medical Services (EMS) status post presumed heroin overdose. He was administered Naloxone 2mg intravenously prior to arrival in the emergency department...
November 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29145501/a-comparison-of-indigenous-and-non-indigenous-survivors-of-sexual-assault-and-their-receipt-of-and-satisfaction-with-specialized-health-care-services
#10
Janice Du Mont, Daisy Kosa, Sheila Macdonald, Anita Benoit, Tonia Forte
In Canada, Indigenous women are more likely than non-Indigenous women to be survivors of sexual assault and experience sexual assaults that are more serious in terms of physical injury and other health-related consequences. Despite their related needs for care and support, there is a paucity of research to date that has examined their uptake of specialized acute health services post sexual assault. To address this gap, we explored the presentation, sociodemographic, assailant, assault, and service use characteristics of Indigenous women, as compared to non-Indigenous adult and adolescent women aged 12 and older presenting to 30 of 35 hospital-based sexual assault treatment centres in Ontario from 2009 to 2011, using bivariate analyses...
2017: PloS One
https://www.readbyqxmd.com/read/29141694/the-icu-diary-study-prospective-multicenter-comparative-study-of-the-impact-of-an-icu-diary-on-the-wellbeing-of-patients-and-families-in-french-icus
#11
Maïté Garrouste-Orgeas, Cécile Flahault, Léonor Fasse, Stéphane Ruckly, Nora Amdjar-Badidi, Laurent Argaud, Julio Badie, Amélie Bazire, Naike Bige, Eric Boulet, Lila Bouadma, Cédric Bretonnière, Bernard Floccard, Alain Gaffinel, Xavier de Forceville, Hubert Grand, Rebecca Halidfar, Olfa Hamzaoui, Mercé Jourdain, Paul-Henri Jost, Eric Kipnis, Audrey Large, Alexandre Lautrette, Olivier Lesieur, Virginie Maxime, Emmanuelle Mercier, Jean Paul Mira, Yannick Monseau, Erika Parmentier-Decrucq, Jean-Philippe Rigaud, Antoine Rouget, François Santoli, Georges Simon, Fabienne Tamion, Nathalie Thieulot-Rolin, Marina Thirion, Sandrine Valade, Isabelle Vinatier, Christel Vioulac, Sebastien Bailly, Jean-François Timsit
BACKGROUND: Post-intensive care syndrome includes the multiple consequences of an intensive care unit (ICU) stay for patients and families. It has become a new challenge for intensivists. Prevention programs have been disappointing, except for ICU diaries, which report the patient's story in the ICU. However, the effectiveness of ICU diaries for patients and families is still controversial, as the interpretation of the results of previous studies was open to criticism hampering an expanded use of the diary...
November 15, 2017: Trials
https://www.readbyqxmd.com/read/29141183/functional-outcomes-of-acute-inpatient-rehabilitation-in-patients-with-chronic-graft-versus-host-disease
#12
Jason Leung, Sean Smith, Claire Kalpakjian
BACKGROUND: Growing numbers of allogeneic stem cell transplants (HSCT) and improved post-transplant care have led to an increase of individuals with chronic graft versus host disease (cGVHD). Although cGVHD leads to functional impairment for many, there is limited literature regarding the benefits of acute inpatient rehabilitation for cGVHD patients. OBJECTIVE: To assess Functional Independence Measure (FIM) outcomes of cGVHD patients during acute inpatient rehabilitation, and to compare inpatient rehabilitation outcomes to burn patients, a rehabilitation patient population with similar co-morbidities...
November 12, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29138486/the-impact-of-a-specialized-spinal-cord-injury-center-as-compared-with-non-specialized-centers-on-the-acute-respiratory-management-of-patients-with-complete-tetraplegia-an-observational-study
#13
Andréane Richard-Denis, Debbie Feldman, Cynthia Thompson, Martin Albert, Jean-Marc Mac-Thiong
STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To compare the proportion of tracheostomy placement and duration of mechanical ventilation (MV) in patients with a complete cervical spinal cord injury (SCI) that were managed early or lately in a specialized acute SCI-center. The second objective was to determine the impact of the timing of admission to the SCI-center on the MV support duration. SETTING: A single Level-1 trauma center specialized in SCI care in Quebec (Canada)...
November 15, 2017: Spinal Cord
https://www.readbyqxmd.com/read/29137580/prevalence-and-predictors-of-persistent-post-surgical-opioid-use-a-prospective-observational-cohort-study
#14
N Stark, S Kerr, J Stevens
Post-surgical opioid prescribing intended for the short-term management of acute pain may lead to long-term opioid use. This study was undertaken to determine the prevalence of persistent post-surgical opioid use and patient-related factors associated with post-surgical opioid use. One thousand and thirteen opioid-naïve patients awaiting elective surgery in a tertiary private hospital in Sydney were enrolled. Preoperatively, patients completed a questionnaire comprising potential predictors of persistent post-surgical opioid use...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29136634/treatment-and-outcomes-of-working-aged-adults-with-stroke-results-from-a-national-prospective-registry
#15
Natasha A Lannin, Craig S Anderson, Joosup Kim, Monique Kilkenny, Julie Bernhardt, Christopher Levi, Helen M Dewey, Christopher Bladin, Peter Hand, Helen Castley, Kelvin Hill, Steven Faux, Rohan Grimley, Brenda Grabsch, Sandy Middleton, Geoffrey Donnan, Dominique A Cadilhac
BACKGROUND: Given the potential differences in etiology and impact, the treatment and outcome of younger patients (aged 18-64 years) require examination separately to older adults (aged ≥65 years) who experience acute stroke. METHODS: Data from the Australian Stroke Clinical Registry (2010-2015) including demographic and clinical characteristics, provision of evidence-based therapies and health-related quality of life (HRQoL) post-stroke was used. Descriptive statistics and multilevel regression models were used for group comparisons...
November 14, 2017: Neuroepidemiology
https://www.readbyqxmd.com/read/29132500/-falls-not-a-priority-insights-on-discharging-older-people-admitted-to-hospital-for-a-fall-back-to-the-community
#16
Claudia Meyer, Emma Renehan, Frances Batchelor, Catherine Said, Terry Haines, Rohan Elliott, Dianne Goeman
Falls are common among older people and a leading cause of injury-related hospitalisation. The immediate post-hospitalisation period is a risky time for further falls. This paper explores discharge strategies from the perspectives of older people hospitalised for a fall and liaison nurses assisting people to return home. Exploratory mixed methods were used. Semi-structured interviews with older people were conducted regarding their experience of the fall and discharge strategies. Quality of life, falls risk and functional capacity were measured by questionnaire...
November 14, 2017: Australian Journal of Primary Health
https://www.readbyqxmd.com/read/29132369/impact-of-pharmacist-led-medication-management-in-care-transitions
#17
Seungwon Yang
BACKGROUND: When patients are discharged from hospital to home, it is a highlighted vulnerable period for which medication - related problems are prevalent. Researchers have proposed a telephone follow-up intervention as a means to reduce hospital readmissions. However, the outcome of the intervention with the engagement of pharmacists in managing patients' medicines after discharge has not been well explored. The objectives of this study were (1) to determine whether a pharmacist telephone follow-up intervention focusing on patients' medicines management support is associated with a reduction in 30-day readmission rates and (2) to describe the number and types of pharmacist interventions in care transitions...
November 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29132152/diagnostic-accuracy-of-screening-tests-and-treatment-for-post-acute-coronary-syndrome-depression-a-systematic-review
#18
Jason A Nieuwsma, John W Williams, Natasha Namdari, Jeffrey B Washam, Giselle Raitz, James A Blumenthal, Wei Jiang, Roshini Yapa, Amanda J McBroom, Kathryn Lallinger, Robyn Schmidt, Andrzej S Kosinski, Gillian D Sanders
Background: Patients who have had an acute coronary syndrome (ACS) event have an increased risk for depression. Purpose: To evaluate the diagnostic accuracy of depression screening instruments and to compare safety and effectiveness of depression treatments in adults within 3 months of an ACS event. Data Sources: MEDLINE, EMBASE, PsycINFO, CINAHL, and Cochrane Database of Systematic Reviews from January 2003 to August 2017, and a manual search of citations from key primary and review articles...
November 14, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29131802/acute-and-one-year-clinical-outcomes-following-implantation-of-bioresorbable-vascular-scaffolds-the-absorb-uk-registry
#19
Andreas Baumbach, Azfar Zaman, Nick Ej West, Peter O'Kane, Mohaned Egred, Thomas Johnson, Stephen Wheatcroft, Bowles Ruth, Adam de Belder, Georgious Bouras, Alexandra Lansky, Jonathan Hill, Anthony Mathur, Mark A de Belder, Adrian Banning
AIMS: The aim was to monitor practice patterns and outcomes in patients treated with Absorb bioresorbable vascular scaffolds (BVS) during the early phase of usage in the UK. METHODS AND RESULTS: A total of 1005 patients with de-novo coronary lesions were treated using careful implantation techniques at 24 centers. Follow-up at one year was obtained in 99%. An independent clinical event committee and angiographic corelab adjudicated all events. Patient age was 52 years and 46% presented with acute coronary syndromes...
November 14, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29131132/points-of-concern-in-post-acute-kidney-injury-management
#20
Jill Vanmassenhove, Raymond Vanholder, Norbert Lameire
The incidence of acute kidney injury (AKI) will in the future remain high, partly due to an increase in comorbidities and other AKI favoring factors such as the rise in high-risk diagnostic and therapeutic interventions. AKI has emerged as a major public health concern with high human and financial costs. It has recently been demonstrated that patients surviving an AKI episode show increased all-cause mortality, chronic kidney disease (CKD), ESRD, cardiovascular events, and reduced quality of life. Although it is important to acknowledge that, after an AKI episode, the risk of dying by far exceeds the risk of developing incident or progressive CKD and/or entering a maintenance renal replacement therapy (RRT) program, currently only a minority of patients are referred for renal follow-up, even after AKI-requiring RRT...
November 2, 2017: Nephron
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