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https://www.readbyqxmd.com/read/28215030/remote-monitoring-to-reduce-heart-failure-readmissions
#1
REVIEW
Sitaramesh Emani
PURPOSE OF REVIEW: Rehospitalization for heart failure remains a challenge in the treatment of affected patients. The ability to remotely monitor patients for worsening heart failure may provide an avenue through which therapeutic interventions can be made to prevent a rehospitalization. Available data on remote monitoring to reduce heart failure rehospitalizations are reviewed within. RECENT FINDINGS: Strategies to reduce readmissions include clinical telemonitoring, bioimpedance changes, biomarkers, and remote hemodynamic monitoring...
February 18, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28214477/hospital-wide-porcine-mesh-conversion-results-in-cost-savings-with-equivalent-clinical-outcomes
#2
Nickolas Byrge, Mary C Mone, Daniel Vargo
BACKGROUND: A variety of biologic mesh is available for ventral hernia repair. Despite widely variable costs, there is no data comparing cost of material to clinical outcome. METHODS: Biologic mesh product change was examined. A prospective survey was done to determine appropriate biologic mesh utilization, followed by a retrospective chart review of those treated from Sept. 2012 to Aug. 2013 with Strattice™ and from Sept. 2013 to Aug. 2014 with Permacol™. Outcome variables included complications associated with each material, repair success, and cost difference over the two periods...
February 12, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28214235/effects-of-postacute-settings-on-readmission-rates-and-reasons-for%C3%A2-readmission-following-total-knee-arthroplasty
#3
Rodney Laine Welsh, James E Graham, Amol M Karmarkar, Natalie E Leland, Jacques G Baillargeon, Dana L Wild, Kenneth J Ottenbacher
OBJECTIVES: Examine the effects of postacute discharge setting on unplanned hospital readmissions following total knee arthroplasty (TKA) in older adults. DESIGN: Secondary analyses of 100% Medicare (inpatient) claims files. SETTING: Acute hospitals across the United States. PARTICIPANTS: Medicare fee-for-service beneficiaries ≥66 years of age who were discharged from an acute hospital following TKA in 2009-2011 (n = 608,031)...
February 14, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28214097/impact-of-an-enhanced-recovery-after-surgery-programme-in-radical-cystectomy-a-cohort-comparative-study
#4
R Casans-Francés, A T Roberto-Alcácer, A C García-Lecina, M L Ferrer-Ferrer, J Subirá-Ríos, J Guillén-Antón
OBJECTIVE: To evaluate the results of the implementation of an enhanced recovery program (ERAS) for open approach radical cystectomy compared to the historical cohort of the same hospital. MATERIAL AND METHODS: A retrospective analysis of 138 consecutive patients who underwent radical cystectomy with Bricker or Studer ileal derivation (97 historical vs. 41 ERAS). Overall complication rate, Clavien-Dindo stage>2 complications, mortality, hospital and critical care length of stay and readmission rates, as well as need for reoperation, nasogastric intubation, transfusion or parenteral nutrition were compared...
February 14, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28213382/pharmacist-involvement-on-a-rapid-response-team
#5
Joel Feih, William J Peppard, Michael Katz
PURPOSE: The effect of a pharmacist on a rapid response team (RRT) was investigated. METHODS: This study evaluated 234 patients before and 157 patients after pharmacist involvement on an RRT. The primary outcome was time to medication administration, with a goal turnaround time of less than 30 minutes. Secondary outcomes included most frequently used medications, readmissions to the intensive care unit (ICU) within 48 hours, number of rapid responses that resulted in ICU admission, length of hospital stay, and survival to hospital discharge...
March 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28210527/major-oncologic-surgery-at-a-community-hospital
#6
Hollyann Loui, Pouya Benyamini, Gregorio Maldini
There is a national trend to refer patients requiring complex oncologic surgery to tertiary high-volume cancer centers. However, this presents major access challenges to Hawai'i patients seeking care. The purpose of this study is to demonstrate that complex oncologic surgery can be safely performed at community hospitals like those in Hawai'i. From July 2007 to December 2014, 136 patients underwent complex oncologic procedures at a community hospital in Hawai'i by a single general surgeon. Cases included esophagogastric, hepatobiliary, pancreatic, rectal, and retroperitoneal resections...
February 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28209152/municipal-resources-and-patient-outcomes-through-the-first-year-after-a-hip-fracture
#7
Sabine Ruths, Valborg Baste, Marit Stordal Bakken, Lars Birger Engesæter, Stein Atle Lie, Siren Haugland
BACKGROUND: Hip fractures represent major critical events for older people, and put huge demands on economic and personnel resources. Most hip fracture patients are in need of postoperative rehabilitation services. Through the Coordination Reform, the municipalities in Norway were given increased responsibility for community-based treatment and rehabilitation after surgery. The purpose of this study was to examine associations between municipal resources and patient outcomes through the first year after a hip fracture, focusing on survival and health-related quality of life...
February 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28209144/modified-enhanced-recovery-after-surgery-eras-protocols-for-patients-with-obstructive-colorectal-cancer
#8
Dai Shida, Kyoko Tagawa, Kentaro Inada, Keiichi Nasu, Yasuji Seyama, Tsuyoshi Maeshiro, Sachio Miyamoto, Satoru Inoue, Nobutaka Umekita
BACKGROUND: Enhanced recovery after surgery (ERAS) protocols are now well-known to be useful for elective colorectal surgery, as they result in shorter hospital stays without adversely affecting morbidity. However, the efficacy and safety of ERAS protocols for patients with obstructive colorectal cancer have yet to be clarified. METHODS: We evaluated 122 consecutive resections for obstructive colorectal cancer performed between July 2008 and November 2012 at Tokyo Metropolitan Bokutoh Hospital...
February 16, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28207971/emergency-department-initiated-home-oxygen-for-bronchiolitis-a-prospective-study-of-community-follow-up-caregiver-satisfaction-and-outcomes
#9
Julia Fuzak Freeman, Sara Deakyne, Lalit Bajaj
OBJECTIVE: Retrospective studies performed have shown home oxygen to be a safe alternative to hospitalization for some patients with bronchiolitis living at high altitudes. We aimed to prospectively describe adverse events, follow-up, duration of home oxygen, factors associated with failure, and caregiver preferences. METHODS: This was a prospective observational study of hypoxemic bronchiolitis patients ages 3-18months who were discharged from a tertiary care pediatric emergency department on home oxygen over 3 winters (2011-2014)...
February 16, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28207595/association-between-anesthesiology-volumes-and-early-and-late-outcomes-after-cystectomy-for-bladder-cancer-a-population-based-study
#10
Melanie T Jaeger, D Robert Siemens, Xuejiao Wei, Paul Peng, Christopher M Booth
BACKGROUND: Hospital and surgeon volume are related to postoperative complications and long-term survival after radical cystectomy. Here, we describe the relationships between these provider characteristics and anesthesiologist volumes on early and late outcomes after radical cystectomy for bladder cancer. METHODS: Records of treatment and surgical pathology reports were linked to the population-based Ontario Cancer Registry to identify all patients with radical cystectomy in Ontario during 1994 to 2008...
February 15, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28205206/apples-and-oranges-four-definitions-of-multiple-chronic-conditions-and-their-relationship-to-30-day-hospital-readmission
#11
Melissa Dattalo, Eva DuGoff, Katie Ronk, Korey Kennelty, Andrea Gilmore-Bykovskyi, Amy J Kind
OBJECTIVES: To determine the extent of agreement between four commonly used definitions of multiple chronic conditions (MCCs) and compare each definition's ability to predict 30-day hospital readmissions. DESIGN: Retrospective cohort study. SETTING: National Medicare claims data. PARTICIPANTS: Random sample of Medicare beneficiaries discharged from the hospital from 2005 to 2009 (n = 710,609). MEASUREMENTS: Baseline chronic conditions were determined for each participant using four definitions of MCC...
February 15, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28204867/right-versus-left-laparoscopic-colectomy-for-colon-cancer-does-side-make-any-difference
#12
Juan P Campana, Pablo A Pellegrini, Gustavo L Rossi, Guillermo Ojea Quintana, Ricardo E Mentz, Carlos A Vaccaro
PURPOSE: To compare the intraoperative and postoperative outcomes between right laparoscopic colectomy (RLC) and left laparoscopic colectomy (LLC) for colon cancer. METHOD: Patients who underwent elective RLC or LLC for colon cancer between January 2004 and December 2014 were identified and elected for a retrospective analysis. Primary outcomes were technical difficulty (including operative time, intraoperative complications, and conversion rate) and postoperative outcome (including postoperative complications, length of hospital stay, reinterventions, readmissions, and mortality)...
February 15, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28203265/cardiometabolic-comorbidities-readmission-and-costs-in-schizophrenia-and-bipolar-disorder-a-real-world-analysis
#13
Christoph U Correll, Daisy S Ng-Mak, Dana Stafkey-Mailey, Eileen Farrelly, Krithika Rajagopalan, Antony Loebel
BACKGROUND: Serious mental illnesses are associated with increased risk of cardiometabolic comorbidities. The objective of this study was to evaluate the prevalence of cardiometabolic comorbidity and its association with hospitalization outcomes and costs among inpatients with schizophrenia or bipolar disorder. METHODS: This retrospective database analysis reviewed patients with an inpatient diagnosis of schizophrenia or bipolar disorder from the Premier Perspective® Database (4/1/2010-6/30/2012)...
2017: Annals of General Psychiatry
https://www.readbyqxmd.com/read/28203071/long-acting-bronchodilators-with-or-without-inhaled-corticosteroids-and-30-day-readmission-in-patients-hospitalized-for-copd
#14
Raju Bishwakarma, Wei Zhang, Yong-Fang Kuo, Gulshan Sharma
BACKGROUND: The ability of a long-acting muscarinic antagonist (LAMA) and long-acting beta 2 agonists (LABAs; long-acting bronchodilators, LABDs) with or without inhaled corticosteroids (ICSs) to reduce early readmission in hospitalized patients with COPD is unknown. METHODS: We studied a 5% sample of Medicare beneficiaries enrolled in Medicare parts A, B and D and hospitalized for COPD in 2011. We examined prescriptions filled for LABDs with or without ICSs (LABDs±ICSs) within 90 days prior to and 30 days after hospitalization...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28203070/determining-prognosis-in-acute-exacerbation-of-copd
#15
Yves Flattet, Nicolas Garin, Jacques Serratrice, Arnaud Perrier, Jérome Stirnemann, Sebastian Carballo
BACKGROUND: Acute exacerbations are the leading causes of hospitalization and mortality in patients with COPD. Prognostic tools for patients with chronic COPD exist, but there are scarce data regarding acute exacerbations. We aimed to identify the prognostic factors of death and readmission after exacerbation of COPD. METHODS: This was a retrospective study conducted in the Department of Internal Medicine of Geneva University Hospitals. All patients admitted to the hospital with a diagnosis of exacerbation of COPD between 2008 and 2011 were included...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28198997/randomized-clinical-trial-of-comprehensive-geriatric-assessment-and-optimization-in-vascular-surgery
#16
J S L Partridge, D Harari, F C Martin, J L Peacock, R Bell, A Mohammed, J K Dhesi
BACKGROUND: Increasing numbers of older patients are undergoing vascular surgery. Inadequate preoperative assessment and optimization may contribute to increased postoperative morbidity and mortality. METHODS: Patients aged at least 65 years scheduled for elective aortic aneurysm repair or lower-limb arterial surgery were enrolled in an RCT of standard preoperative assessment or preoperative comprehensive geriatric assessment and optimization. Randomization was stratified by sex and surgical site (aorta/lower limb)...
February 15, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28194877/focused-breastfeeding-counselling-improves-short-and-long-term-success-in-an-early-discharge-setting-a-cluster-randomized-study
#17
Ingrid M S Nilsson, Katrine Strandberg-Larsen, Christopher H Knight, Anne Vinkel Hansen, Hanne Kronborg
Length of postnatal hospitalization has decreased and has been shown to be associated with infant nutritional problems and increase in readmissions. We aimed to evaluate if guidelines for breastfeeding counselling in an early discharge hospital setting had an effect on maternal breastfeeding self-efficacy, infant readmission and breastfeeding duration. A cluster randomized trial was conducted and assigned nine maternity settings in Denmark to intervention or usual care. Women were eligible if they expected a single infant, intended to breastfeed, were able to read Danish, and expected to be discharged within 50 hr postnatally...
February 14, 2017: Maternal & Child Nutrition
https://www.readbyqxmd.com/read/28192556/changes-in-postacute-care-in-the-medicare-shared-savings-program
#18
J Michael McWilliams, Lauren G Gilstrap, David G Stevenson, Michael E Chernew, Haiden A Huskamp, David C Grabowski
Importance: Postacute care is thought to be a major source of wasteful spending. The extent to which accountable care organizations (ACOs) can limit postacute care spending has implications for the importance and design of other payment models that include postacute care. Objective: To assess changes in postacute care spending and use of postacute care associated with provider participation as ACOs in the Medicare Shared Savings Program (MSSP) and the pathways by which they occurred...
February 13, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28192477/impact-of-early-in-hospital-medication-review-by-clinical-pharmacists-on-health-services-utilization
#19
Corinne M Hohl, Nilu Partovi, Isabella Ghement, Maeve E Wickham, Kimberlyn McGrail, Lisa N Reddekopp, Boris Sobolev
BACKGROUND: Adverse drug events are a leading cause of emergency department visits and unplanned admissions, and prolong hospital stays. Medication review interventions aim to identify adverse drug events and optimize medication use. Previous evaluations of in-hospital medication reviews have focused on interventions at discharge, with an unclear effect on health outcomes. We assessed the effect of early in-hospital pharmacist-led medication review on the health outcomes of high-risk patients...
2017: PloS One
https://www.readbyqxmd.com/read/28192259/impact-of-intraoperative-monitoring-during-elective-complex-spinal-fusions-%C3%A2-4-levels-on-30-day-complication-and-readmission-rates-a-single-institutional-study-of-643-adult-spinal-deformity-patients
#20
Aladine A Elsamadicy, Owoicho Adogwa, Emily Lydon, Gireesh Reddy, Rayan Kaakati, Amanda Sergesketter, Oren N Gottfried, Isaac O Karikari
OBJECTIVE: The aim of this study is to determine if there are differences in 30-day postoperative complication and readmission rates between spinal deformity patients undergoing complex spinal fusion with and without intraoperative monitoring. METHODS: The medical records of 643 adult spine deformity patients undergoing elective complex spinal fusion (≥4 levels) at a major academic institution from 2005 to 2015 were reviewed. We identified 122 (19%) cases that involved intraoperative monitoring (IOM) including EMG, SSEP, and/or TcMEP and 521 (81%) that did not (IOM: n=122; No-IOM: n=521)...
February 9, 2017: World Neurosurgery
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