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https://www.readbyqxmd.com/read/28538534/enhanced-recovery-after-surgery-for-hip-and-knee-replacements
#1
David P Gwynne-Jones, Ginny Martin, Chris Crane
BACKGROUND: Enhanced recovery after surgery (ERAS) programs or hip and knee replacements have had a significant effect on streamlining patient care with shorter stays, no increase in complications, and improved outcomes including reduced mortality. PURPOSE: To compare outcomes following the introduction of an ERAS program for hip and knee replacements developed at our institution with a historical cohort of patients. METHODS: ERAS protocols were developed at our institution for patients undergoing hip and knee joint replacements...
May 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28538139/advanced-musculoskeletal-physiotherapists-are-effective-and-safe-in-managing-patients-with-acute-low-back-pain-presenting-to-emergency-departments
#2
James M Sayer, Rita M Kinsella, Belinda A Cary, Angela T Burge, Lara A Kimmel, Paula Harding
Objective The aim of this study was to compare emergency department (ED) key performance indicators for patients presenting with low back pain and seen by an advanced musculoskeletal physiotherapist (AMP) with those seen by other non-AMP clinicians (ED doctors and nurse practitioners).Methods A retrospective audit (October 2012-September 2013) was performed of data from three metropolitan public hospital EDs to compare patients with low back pain seen by AMP and non-AMP clinicians. Outcome measures included ED length of stay, ED wait time, admission rates and re-presentation to the ED...
May 25, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28535223/hospital-level-variation-in-postpartum-readmissions
#3
Mark A Clapp, Sarah E Little, Jie Zheng, Anjali J Kaimal, Julian N Robinson
No abstract text is available yet for this article.
May 23, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28533037/epidemiology-of-live-born-infants-with-nonimmune-hydrops-fetalis-insights-from-a-population-based-dataset
#4
Martina A Steurer, Shabnam Peyvandi, Rebecca J Baer, Tippi MacKenzie, Ben C Li, Mary E Norton, Laura L Jelliffe-Pawlowski, Anita J Moon-Grady
OBJECTIVE: To evaluate the incidence, etiology, and 1-year mortality of nonimmune hydrops fetalis (NIHF) and to identify risk factors for mortality in a contemporary population-based dataset. STUDY DESIGN: The California Office of Statewide Health Planning and Development maintains a database linking maternal and infant hospital discharge, readmissions, and birth and death certificate date from 1 year before to 1 year after birth. We searched the database (2005-2012) for infants with NIHF (identified by the International Classification of Diseases, 9th Revision, Clinical Modification code)...
May 19, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28532710/early-hospital-readmission-among-hemodialysis-patients-in-the-united-states-is-associated-with-subsequent-mortality
#5
Laura C Plantinga, Laura King, Rachel E Patzer, Janice P Lea, John M Burkart, Jason M Hockenberry, Bernard G Jaar
Dialysis providers in the United States may soon be held accountable for their patients' 30-day hospital readmissions. However, few studies have evaluated the timing of readmissions, which determines the window in which dialysis providers could act to prevent readmission. We therefore examined the timing of readmissions of hemodialysis patients in the United States and its association with mortality among 285,795 prevalent adult Medicare-primary hemodialysis patients from a national registry. Patients had at least one hospitalization in 2010-2013 (first index) and survived for 30 days or more...
May 20, 2017: Kidney International
https://www.readbyqxmd.com/read/28532575/readmission-rates-after-transcatheter-aortic-valve-replacement-in-high-and-extreme-risk-patients-with-severe-aortic-stenosis
#6
Jessica Forcillo, Jose F Condado, Jose N Binongo, Yi Lasanajak, Hope Caughron, Vasilis Babaliaros, Chandan Devireddy, Bradley Leshnower, Robert A Guyton, Peter C Block, Amy Simone, Patricia Keegan, Paul Khairy, Vinod H Thourani
OBJECTIVE: In high- or extreme-risk patients undergoing transcatheter aortic valve replacement, readmissions have not been adequately studied and are the subject of increased scrutiny by healthcare systems. The objectives of this study were to determine the incidence of 30-day and 1-year cardiac and noncardiac readmissions, identify predictors of readmission, and assess the association between readmission and 1-year mortality. METHODS: A retrospective review was performed on 714 patients who underwent transcatheter aortic valve replacement from September 2007 to January 2015 at Emory University...
April 18, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28531888/right-trac%C3%A2-post-hospitalization-care-transitions-program-to-reduce-readmissions-for-hemodialysis-patients
#7
Rebecca L Wingard, Kathryn McDougall, Billie Axley, Andrew Howard, Cathleen O'Keefe, Nancy Armistead, Janet R Lynch, Sophia Rosen, Len Usvyat, Franklin W Maddux
BACKGROUND: Hemodialysis (HD) patients have high hospitalization rates. This nonrandomized trial tested the effect of a bundle of renal-specific "Right TraC™" strategies on 30-day all-cause readmission rates and, secondarily, 90-day readmissions and overall admissions among HD patients. METHODS: Twenty-six Fresenius clinics in West Virginia, Ohio, and Kentucky participated in the interventions. Eighteen matched clinics served as controls; intervention clinics also served as their own controls...
May 23, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28531289/management-of-bacteriuria-in-veterans-affairs-hospitals
#8
Emily S Spivak, Muriel Burk, Rongping Zhang, Makoto M Jones, Melinda M Neuhauser, Matthew Bidwell Goetz, Francesca E Cunningham
Background: Bacteriuria contributes to antibiotic overuse through treatment of asymptomatic bacteriuria (ASB) and long durations of therapy for symptomatic urinary tract infections (UTIs), yet large-scale evaluations of bacteriuria management among inpatients are lacking. Methods: Inpatients with bacteriuria were classified as asymptomatic or symptomatic based on established criteria applied to data collected by manual chart review. We examined frequency of treatment of ASB, factors associated with treatment of ASB, durations of therapy, and frequency of complications including Clostridium difficile infection, readmission and all-cause mortality within 28 days of discharge...
May 20, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28531254/frailty-status-at-admission-to-hospital-predicts-multiple-adverse-outcomes
#9
Ruth E Hubbard, Nancye M Peel, Mayukh Samanta, Leonard C Gray, Arnold Mitnitski, Kenneth Rockwood
Aims: frailty is proposed as a summative measure of health status and marker of individual vulnerability. We aimed to investigate the discriminative capacity of a frailty index (FI) derived from interRAI Comprehensive Geriatric Assessment for Acute Care (AC) in relation to multiple adverse inpatient outcomes. Methods: in this prospective cohort study, an FI was derived for 1,418 patients ≥70 years across 11 hospitals in Australia. The interRAI-AC was administered at admission and discharge by trained nurses, who also screened patients daily for geriatric syndromes...
May 22, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28530779/predictive-factors-for-early-hospital-readmission-and-1-year-mortality-in-elder-patients-following-surgical-treatment-of-a-hip-fracture
#10
Hakan Sofu, Hanifi Üçpunar, Yalkın Çamurcu, Serda Duman, Mehmet Nuri Konya, Sarper Gürsu, Vedat Şahin
BACKGROUND: Early hospital readmission after surgically treated hip fracture is a common entity, often involving an adverse event and causing strains on an already overburdened healthcare system. The main purposes of the present study were to determine the 30-day readmission rate, analyze the predictive factors for early hospital readmissions, and assess 1-year mortality following surgical treatment of hip fracture in elderly patients. Retrospective case-control study. METHODS: In total, 517 patients with a mean age of 74 years were evaluated...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28530118/readmission-to-intensive-care-unit-incidence-risk-factors-resource-use-and-outcomes-a-retrospective-cohort-study
#11
Carolina R Ponzoni, Thiago D Corrêa, Roberto R Filho, Ary Serpa Neto, Murillo Sc Assunção, Andreia Pardini, Guilherme Pp Schettino
RATIONALE: Readmission to intensive care unit (ICU) is associated with poor clinical outcomes, increased length of ICU and hospital stay and higher costs. Nevertheless, knowledge on epidemiology of ICU readmissions, risk factors and attributable outcomes are restricted to developed countries. OBJECTIVES: Determine the effect of ICU readmissions on in-hospital mortality, incidence of ICU readmissions, identify predictors of ICU readmissions and hospital mortality and compare resource use and outcomes between readmitted and nonreadmitted patients in a developing country...
May 21, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28528348/effect-of-home-noninvasive-ventilation-with-oxygen-therapy-vs-oxygen-therapy-alone-on-hospital-readmission-or-death-after-an-acute-copd-exacerbation-a-randomized-clinical-trial
#12
Patrick B Murphy, Sunita Rehal, Gill Arbane, Stephen Bourke, Peter M A Calverley, Angela M Crook, Lee Dowson, Nicholas Duffy, G John Gibson, Philip D Hughes, John R Hurst, Keir E Lewis, Rahul Mukherjee, Annabel Nickol, Nicholas Oscroft, Maxime Patout, Justin Pepperell, Ian Smith, John R Stradling, Jadwiga A Wedzicha, Michael I Polkey, Mark W Elliott, Nicholas Hart
Importance: Outcomes after exacerbations of chronic obstructive pulmonary disease (COPD) requiring acute noninvasive ventilation (NIV) are poor and there are few treatments to prevent hospital readmission and death. Objective: To investigate the effect of home NIV plus oxygen on time to readmission or death in patients with persistent hypercapnia after an acute COPD exacerbation. Design, Setting, and Participants: A randomized clinical trial of patients with persistent hypercapnia (Paco2 >53 mm Hg) 2 weeks to 4 weeks after resolution of respiratory acidemia, who were recruited from 13 UK centers between 2010 and 2015...
May 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28527931/predictors-of-surgical-site-infection-after-open-lower-extremity-revascularization
#13
Frank M Davis, Danielle C Sutzko, Scott F Grey, M Ashraf Mansour, Krishna M Jain, Timothy J Nypaver, Greg Gaborek, Peter K Henke
OBJECTIVE: Surgical site infection (SSI) after open lower extremity bypass (LEB) is a serious complication leading to an increased rate of graft failure, hospital readmission, and health care costs. This study sought to identify predictors of SSI after LEB for arterial occlusive disease and also potential modifiable factors to improve outcomes. METHODS: Data from a statewide cardiovascular consortium of 35 hospitals were used to obtain demographic, procedural, and hospital risk factors for patients undergoing elective or urgent open LEB between January 2012 and June 2015...
June 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28527729/the-hospitalization-profiles-of-patients-with-or-without-diabetes-treated-for-nontraumatic-lower-extremity-amputation-in-ribeir%C3%A3-o-preto-s%C3%A3-o-paulo-state-brazil-2001-2008
#14
Flávia F L Rodrigues, Domingos Alves, Carla R S Teixeira, Clarissa C A Arrelias, Maria T C G Torquato, Manoel A Santos, Maria Lucia Zanetti
The aim of this retrospective study was to assess the hospitalizations of patients with or without diabetes mellitus (DM) who underwent nontraumatic lower extremity amputation (NLEA) with regard to demographic and hospitalization-related variables. It is a high proportion of hospital beds in developing countries, for patients with diabetes mellitus with lower extremity complications. Nontraumatic amputations of lower extremities rates is an important indicator to assess the effectiveness of efforts to reduce chronic complications related to diabetic foot...
June 2017: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
https://www.readbyqxmd.com/read/28527613/no-344-opportunistic-salpingectomy-and-other-methods-of-risk-reduction-for-ovarian-fallopian-tube-peritoneal-cancer-in-the-general-population
#15
Shannon Salvador, Stephanie Scott, Julie Ann Francis, Anita Agrawal, Christopher Giede
OBJECTIVE: This guideline reviews the potential benefits of opportunistic salpingectomy to prevent the development of high grade serous cancers (HGSC) of the ovary/fallopian tube/peritoneum based on current evidence supporting the fallopian tube origin of disease. INTENDED USERS: Gynaecologists, obstetricians, family doctors, registered nurses, nurse practitioners, residents, and health care providers. TARGET POPULATION: Adult women (18 and older): OPTIONS: Women considering hysterectomy who wish to retain their ovaries in situ have traditionally also retained their fallopian tubes...
June 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28526309/antimicrobial-stewardship-for-hospitalized-patients-with-viral-respiratory-tract-infections
#16
Christopher F Lowe, Michael Payne, David Puddicombe, Allison Mah, Davie Wong, Allison Kirkwood, Mark W Hull, Victor Leung
BACKGROUND: The purpose of this study was to implement a targeted antimicrobial stewardship intervention for patients with a viral respiratory tract infection. METHODS: This was a quasi-experimental before and after audit and feedback intervention of adult inpatients with a positive polymerase chain reaction for a respiratory virus in 2 acute care hospitals in Vancouver, Canada. Audit and feedback was implemented based on 2 criteria: microbiology (no positive bacterial cultures) and chest imaging (absence of pneumonia or consolidation on radiology dictation)...
May 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28526241/-guidelines-for-prevention-detection-and-management-of-hyperbilirubinaemia-in-newborns-of-35-or-more-weeks-of-gestation
#17
María Dolores Sánchez-Redondo Sánchez-Gabriel, José Luis Leante Castellanos, Isabel Benavente Fernández, Alejandro Pérez Muñuzuri, Segundo Rite Gracia, Cesar W Ruiz Campillo, Ester Sanz López, Manuel Sánchez Luna
Hyperbilirubinaemia is one of the most frequent causes of hospital readmission during the first week of life. Its detection is still a big challenge, mainly due to the early discharge from the hospital that can be associated with a delay of the diagnosis. The identification of those newborns at risk of developing significant hyperbilirubinaemia is one of the main priorities in the public health care system. An approach to the management of newborn jaundice is presented in this article, following the recommendations based on the medical evidence and on the opinion of the Standards Committee of the Spanish Society of Neonatology...
May 16, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28523732/long-term-respiratory-outcomes-after-primary-total-correction-for-tetralogy-of-fallot-and-absent-pulmonary-valve-in-patient-with-respiratory-symptoms
#18
Takaya Hoashi, Toru Iwasa, Koji Kagisaki, Masatoshi Shimada, Kenichi Kurosaki, Isao Shiraishi, Hajime Ichikawa
OBJECTIVE: To review long-term respiratory outcomes for tetralogy of Fallot and absent pulmonary valve (TOF/APV) in respiratory symptomatic populations. METHODS: Of 25 consecutive patients undergoing primary total correction for TOF/APV between 1987 and 2016, Sixteen patients (64%) with a preoperative respiratory disturbance were enrolled. The median age at operation was 1.9 months old, including 4 neonates and 12 infants. Ten patients (62.5%) preoperatively necessitated mechanical ventilator support...
May 19, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28523476/impact-of-a-patient-navigator-program-on-hospital-based-and-outpatient-utilization-over-180%C3%A2-days-in-a-safety-net-health-system
#19
Richard B Balaban, Fang Zhang, Catherine E Vialle-Valentin, Alison A Galbraith, Marguerite E Burns, Marc R Larochelle, Dennis Ross-Degnan
BACKGROUND: With emerging global payment structures, medical systems need to understand longer-term impacts of care transition strategies. OBJECTIVE: To determine the effect of a care transition program using patient navigators (PNs) on health service utilization among high-risk safety-net patients over a 180-day period. DESIGN: Randomized controlled trial conducted October 2011 through April 2013. PARTICIPANTS: Patients admitted to the general medicine service with ≥1 readmission risk factor: (1) age ≥ 60; (2) in-network inpatient admission within prior 6 months; (3) index length of stay ≥ 3 days; or (4) admission diagnosis of heart failure or (5) chronic obstructive pulmonary disease...
May 18, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28523370/use-of-tolvaptan-vs-furosemide-in-older-patients-with-heart-failure-meta-analysis-of-randomized-controlled-trials
#20
W-L Huang, Y Yang, J Yang, J Yang, H-B Wang, X-L Xiong, Y-F Zhang
BACKGROUND: It is not known whether older patients with acute heart failure (HF) receiving tolvaptan have decreased mortality rates and a better long-term prognosis than patients who receive furosemide. We conducted a systematic review of randomized controlled trials (RCTs) to address this issue. METHODS: The Medline, Embase, and Cochrane Library databases were searched for English-language RCTs published before September 2016 comparing tolvaptan with furosemide treatment in older patients (>65 years old) after acute HF...
May 18, 2017: Herz
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