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https://www.readbyqxmd.com/read/29679151/comparisons-of-the-surgical-outcomes-and-medical-costs-between-transferred-and-directly-admitted-patients-diagnosed-with-intestinal-obstruction-in-an-american-tertiary-referral-center
#1
Xian Hua Gao, Hanumant Chouhan, Emre Gorgun, Luca Stocchi, Gokhan Ozuner
PURPOSE: Intestinal obstruction is a leading cause of patient mortality and the most common reason for emergent operation in colorectal surgery. The influence of inter-hospital transfer on patients' outcomes varies greatly in different diseases. We aimed to compare the surgical outcomes and medical costs between transferred and directly admitted patients diagnosed with intestinal obstruction in an American tertiary referral center. METHODS: All intestinal obstruction patients operated in Cleveland Clinic from Jan 2012 to Dec 2016 were collected from a prospectively maintained database...
April 20, 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29678985/impact-of-tailored-falls-prevention-education-for-older-adults-at-hospital-discharge-on-engagement-in-falls-prevention-strategies-postdischarge-protocol-for-a-process-evaluation
#2
Chiara Naseri, Steven M McPhail, Julie Netto, Terrence P Haines, Meg E Morris, Christopher Etherton-Beer, Leon Flicker, Den-Ching A Lee, Jacqueline Francis-Coad, Anne-Marie Hill
INTRODUCTION: Older adults recently discharged from hospital have greater incidence of adverse events, functional decline, falls and subsequent readmission. Providing education to hospitalised patients on how to prevent falls at home could reduce postdischarge falls. There has been limited research investigating how older adults respond to tailored falls prevention education provided at hospital discharge. The aim of this study is to evaluate how providing tailored falls prevention education to older patients at the point of, and immediately after hospital discharge in addition to usual care, affects engagement in falls prevention strategies in the 6-months postdischarge period, including their capability and motivation to engage in falls prevention strategies...
April 20, 2018: BMJ Open
https://www.readbyqxmd.com/read/29678620/coronary-artery-bypass-graft-readmission-rates-and-risk-factors-a-retrospective-cohort-study
#3
T Robert Feng, Robert S White, Licia K Gaber-Baylis, Zachary A Turnbull, Lisa Q Rong
BACKGROUND: Hospital readmissions contribute substantially to the overall healthcare cost. Coronary artery bypass graft (CABG) is of particular interest due to its relatively high short-term readmission rates and mean hospital charges. METHODS: A retrospective review was performed on 2007-2011 data from California, Florida, and New York from the State Inpatient Databases, Healthcare Cost and Utilization Project. All patients ≥18 years of age who underwent isolated CABG and met inclusion/exclusion criteria were included...
April 17, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29676782/evaluation-of-the-cincinnati-veterans-affairs-medical-center-hospital-in-home-program
#4
Shubing Cai, Andrew Grubbs, Rajesh Makineni, Bruce Kinosian, Ciaran S Phibbs, Orna Intrator
OBJECTIVES: To examine hospital readmissions, costs, mortality, and nursing home admissions of veterans who received Hospital-in-Home (HIH) services. DESIGN: Retrospective cohort study. SETTING: Cincinnati Veterans Affairs Medical Center (VAMC). PARTICIPANTS: Study cohort included veterans who received HIH services as an alternative to inpatient care between October 1, 2012, and November 30, 2015, and non-HIH veterans who were hospitalized for similar conditions in the Cincinnati VAMC during the same period...
April 20, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29676777/do-not-resuscitate-orders-in-older-adults-during-hospitalization-a-propensity-score-matched-analysis
#5
Karishma Patel, Liron Sinvani, Vidhi Patel, Andrzej Kozikowski, Christopher Smilios, Meredith Akerman, Kinga Kiszko, Sutapa Maiti, Negin Hajizadeh, Gisele Wolf-Klein, Renee Pekmezaris
OBJECTIVES: To explore the effect of the presence and timing of a do-not-resuscitate (DNR) order on short-term clinical outcomes, including mortality. DESIGN: Retrospective cohort study with propensity score matching to enable direct comparison of DNR and no-DNR groups. SETTING: Large, academic tertiary-care center. PARTICIPANTS: Hospitalized medical patients aged 65 and older. MEASUREMENTS: Primary outcome was in-hospital mortality...
April 20, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29676053/increasing-success-in-outpatient-laparoscopic-cholecystectomy-by-an-optimal-clinical-pathway
#6
Tristan Greilsamer, François Orion, Fabrice Denimal, Benoît De Kerviler, Marc-Henri Jean, Jérôme Dimet, Michel Comy, Emeric Abet
BACKGROUND: The objective of this study was to evaluate the impact of more convincing and reassuring remarks from the surgeon in the preoperative consult associated with a dedicated outpatient facility to increase our rate of success in outpatient laparoscopic cholecystectomy. METHODS: A one-centre prospective clinical study was conducted between February 2013 and May 2015. During the first time period (February 2013-March 2014), patients were hospitalized in conventional care unit and given the possibility to choose an outpatient procedure...
April 19, 2018: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29676033/fio-2-control-by-parents-of-preterm-infants-admitted-to-a-neonatal-intensive-care-unit-a-pilot-study
#7
M D Martín-Pelegrina, A Lorenzo-Rodríguez, D Lora-Pablos, B Muñóz-Amat, C Morales-Betancourt, C R Pallás-Alonso
When newborns are admitted to the neonatal intensive care unit for prematurity or other reasons, parents do not take on the role that they were expecting to assume. That is, they do not become the main caregivers of their children. To address this issue, neonatal units are currently trying to involve parents in the care of their children as soon as possible. Interesting experiences regarding this issue have been published. Most of the experiences show that when parents assume part of the responsibility for caring for their children, breastfeeding is prolonged, hospital-stay lengths decrease, weight gain increases and the numbers of readmissions decrease (1-4)...
April 19, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29675545/a-novel-approach-to-improving-ambulatory-outpatient-management-of-low-risk-febrile-neutropenia-an-enhanced-supportive-care-esc-clinic
#8
Tim Cooksley, Geraldine Campbell, Tamer Al-Sayed, Lisa LaMola, Richard Berman
PURPOSE: Outpatient management of low risk febrile neutropenia patients (LRFN) identified by the MASCC score is a safe and effective strategy. Early supportive care has been shown to improve outcomes in patients with care. We developed an innovative ambulatory outpatient "enhanced supportive care" (ESC) clinic combining emergency oncology and supportive care through which we incorporated the management of patients with LRFN. METHODS: An ESC clinic was started in January 2017 at a tertiary cancer hospital in the North West of England...
April 19, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29673830/is-telehealth-effective-in-managing-malnutrition-in-community-dwelling-older-adults-a-systematic-review-and-meta-analysis
#9
REVIEW
Wolfgang Marx, Jaimon T Kelly, Megan Crichton, Dana Craven, Jorja Collins, Hannah Mackay, Elizabeth Isenring, Skye Marshall
Telehealth offers a feasible method to provide nutrition support to malnourished older adults. This systematic review and meta-analysis aims to determine the efficacy of telehealth methods in delivering malnutrition-related interventions to community-dwelling older adults. Studies in any language were searched in five electronic databases from inception to 2nd November 2017. Quality of the evidence was assessed using the Cochrane Risk of Bias tool and the GRADE approach. Nine studies were identified, with results published across 13 included publications, which had mostly low to unclear risk of bias...
May 2018: Maturitas
https://www.readbyqxmd.com/read/29673829/improving-the-rehabilitation-of-older-people-after-emergency-hospital-admission
#10
REVIEW
S McKelvie, A M Hall, H R Richmond, S Finnegan, D Lasserson
PURPOSE: Older adults are at risk of functional decline during emergency hospital admissions. This review aims to understand which exercise-based interventions are effective in improving function for older adults who experience unplanned admissions. METHODS: Database searches identified randomised control trials (RCTs) comparing exercise-based interventions with usual hospital care. The primary outcome was functional status measured by activities of daily living (ADL) scores...
May 2018: Maturitas
https://www.readbyqxmd.com/read/29673571/the-effect-of-hospital-acuity-on-severe-maternal-morbidity-in-high-risk-patients
#11
Mark A Clapp, Kaitlyn E James, Anjali J Kaimal
BACKGROUND: In 2015, the Society for Maternal-Fetal Medicine and the American College of Obstetricians and Gynecologists published guidelines that established levels of maternal care. These guidelines outline the nursing, provider, and facility requirements for hospitals to be designated a birthing center or one of four levels of care. To-date, these levels of maternal care have not been widely adopted, and currently, no data exists on how these designations may affect maternal or neonatal outcomes...
April 16, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29672991/glycaemic-optimization-for-patients-with-cardiac-disease-a-before-and-after-study
#12
Tripti Joshi, Sarah-Jane Pullen, Alison Gebuehr, Christopher Oldmeadow, John Richard Attia, Shamasunder Halady Acharya
AIM: To investigate if glycaemic profiles and outcomes of patients with diabetes admitted for cardiothoracic surgery or acute coronary syndrome improved after implementation of a structured glycaemia management guideline. METHODS: This is a retrospective before-and-after comparative analysis of outcomes for all consecutive cardiothoracic and acute coronary syndrome patients with diabetes (N = 375), who were admitted at our tertiary-care university-affiliated hospital during the preguideline period (July-December, 2013) and the postguideline period (July-December, 2014)...
April 19, 2018: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/29672983/rural-urban-variation-in-injury-related-hospitalisation-health-outcomes-and-treatment-cost-in-new-south-wales
#13
Rebecca J Mitchell, Tony Lower
OBJECTIVE: To compare differences in injury characteristics, health outcomes and treatment costs between urban and rural residents who were hospitalised following an injury. DESIGN: A retrospective examination of injury-linked hospitalisation and mortality data in New South Wales from 1 January 2010 to 30 June 2014. PARTICIPANTS: Urban (496 325) and rural (213 139) residents who were hospitalised following an injury. MAIN OUTCOME MEASURES: Demographic and injury characteristics, injury severity, hospital length of stay, 28-day hospital readmission, 90-day mortality and treatment cost...
April 19, 2018: Australian Journal of Rural Health
https://www.readbyqxmd.com/read/29672409/association-of-preoperative-anticholinergic-medication-exposure-with-postoperative-healthcare-resource-use-and-outcomes-a-population-based-cohort-study
#14
Daniel I McIsaac, Coralie A Wong, Deric Diep, Carl van Walraven
OBJECTIVE: The aim of this study was to measure the association of preoperative anticholinergic exposure with length of stay (LOS) and other outcomes in older people having elective noncardiac surgery. SUMMARY BACKGROUND DATA: Anticholinergic medications are associated with adverse events in nonsurgical populations; the association of anticholinergic medications with outcomes in elective surgery patients is poorly described. METHODS: We conducted a retrospective, population-based cohort study using linked administrative data in Ontario, Canada...
April 18, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29672398/evaluating-quality-metrics-and-cost-after-discharge-a-population-based-cohort-study-of-value-in-health-care-following-elective-major-vascular-surgery
#15
Charles de Mestral, Konrad Salata, Mohamad A Hussain, Ahmed Kayssi, Mohammed Al-Omran, Graham Roche-Nagle
BACKGROUND: Early readmission to hospital after surgery is an omnipresent quality metric across surgical fields. We sought to understand the relative importance of hospital readmission among all health services received after hospital discharge. OBJECTIVE: The aim of this study was to characterize 30-day postdischarge cost and risk of an emergency department (ED) visit, readmission, or death after hospitalization for elective major vascular surgery. METHODS: This is a population-based retrospective cohort study of patients who underwent elective major vascular surgery - carotid endarterectomy, EVAR, open AAA repair, bypass for lower extremity peripheral arterial disease - in Ontario, Canada, between 2004 and 2015...
April 18, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29672391/wound-care-center-of-excellence-a-process-for-continuous-monitoring-and-improvement-of-wound-care-quality
#16
Raelina S Howell, Lauren S Kohan, Jon S Woods, Theresa Criscitelli, Brian M Gillette, Virginia Donovan, Scott Gorenstein
To provide information about a study using a new process for continuous monitoring to improve chronic wound care quality.This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.After completing this continuing education activity, you should be better able to:1. Recognize problems associated with chronic wound care.2. Identify methods used in this project to improve care.3. Illustrate the findings from this and similar projects and implications for providing improved wound care...
May 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29672242/developing-and-implementing-a-heart-failure-data-mart-for-research-and-quality-improvement
#17
Erin Abu-Rish Blakeney, Seth Wolpin, Danielle C Lavallee, Todd Dardas, Richard Cheng, Brenda Zierler
OBJECTIVE: The purpose of this project was to build and formatively evaluate a near-real time heart failure (HF) data mart. Heart Failure (HF) is a leading cause of hospital readmissions. Increased efforts to use data meaningfully may enable healthcare organizations to better evaluate effectiveness of care pathways and quality improvements, and to prospectively identify risk among HF patients. METHODS AND PROCEDURES: We followed a modified version of the Systems Development Life Cycle: 1) Conceptualization, 2) Requirements Analysis, 3) Iterative Development, and 4) Application Release...
April 19, 2018: Informatics for Health & Social Care
https://www.readbyqxmd.com/read/29670391/determining-30-day-readmission-risk-for-heart-failure-patients-the-readmission-after-heart-failure-scale
#18
Ronald S Chamberlain, Jaswinder Sond, Krishnaraj Mahendraraj, Christine Sm Lau, Brianna L Siracuse
Background: Chronic heart failure (CHF), which affects >5 million Americans, accounts for >1 million hospitalizations annually. As a part of the Hospital Readmission Reduction Program, the Affordable Care Act requires that the Centers for Medicare and Medicaid Services reduce payments to hospitals with excess readmissions. This study sought to develop a scale that reliably predicts readmission rates among patients with CHF. Methods: The State Inpatient Database (2006-2011) was utilized, and discharge data including demographic and clinical characteristics on 642,448 patients with CHF from California and New York (derivation cohort) and 365,359 patients with CHF from Florida and Washington (validation cohort) were extracted...
2018: International Journal of General Medicine
https://www.readbyqxmd.com/read/29669970/prognostic-relevance-of-liver-stiffness-assessed-by-transient-elastography-in-patients-with-acute-decompensated-heart-failure
#19
Yuki Saito, Mahoto Kato, Koichi Nagashima, Koyuru Monno, Yoshihiro Aizawa, Yasuo Okumura, Naoki Matsumoto, Mitsuhiko Moriyama, Atsushi Hirayama
BACKGROUND: Acute decompensated heart failure (ADHF) is often accompanied by liver congestion through increased right atrial pressure (RAP). Liver stiffness (LS) assessed non-invasively using transient elastography is related to increased RAP and liver congestion in patients with general HF. We investigated the relationship of LS with clinical and echocardiographic variables and outcomes in patients with ADHF.Methods and Results:The subjects were 105 patients with ADHF admitted to hospital between October 2016 and June 2017...
April 17, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29669197/complications-of-total-hip-arthroplasty-in-patients-with-ankylosing-spondylitis
#20
Michael M Ward
BACKGROUND: To compare the risks of complications of primary total hip arthroplasty (THA) between patients with ankylosing spondylitis (AS) and those without AS. METHODS: In this population-based study, we examined U.S. Medicare beneficiaries (< 75 years old) with AS and a comparison group without AS who had primary THA in 1999 - 2013. Complications were based on the 2013 Centers for Medicare & Medicaid Services THA Complication Measure, which included myocardial infarction, pneumonia, and sepsis within 7 days; surgical site bleeding, pulmonary embolus, or venous thrombosis within 30 days; and mechanical complications or local infection within 90 days...
April 18, 2018: Arthritis Care & Research
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