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https://www.readbyqxmd.com/read/29766305/evaluation-of-vte-prophylaxis-and-the-impact-of-alternate-regimens-on-post-operative-bleeding-and-thrombotic-complications-following-bariatric-procedures
#1
Maria S Altieri, Jie Yang, Janos Hajagos, Konstantinos Spaniolas, Jihye Park, Antonios P Gasparis, Andrew T Bates, Salvatore Docimo, Mark Talamini, A Laurie Shroyer, Aurora D Pryor
BACKGROUND: Studies examining utilization and impact of venous thromboembolism (VTE) chemoprophylaxis for patients undergoing bariatric surgery are limited. Determination of the optimal prophylactic regimen to minimize complications is crucial. METHODS: The Cerner Health Facts database from 2003 to 2013 was queried using ICD-9 codes to identify patients undergoing laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (RYGB). VTE chemoprophylaxis regimens were divided into pre-operative alone (PreP), post-operative alone (PostP), both pre-operative and post-operative (PPP), or no prophylaxis (NP)...
May 15, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29707092/improved-outcomes-associated-with-the-use-of-intravenous-acetaminophen-for-management-of-acute-post-surgical-pain-in-cesarean-sections-and-hysterectomies
#2
Richard D Urman, Elaine A Boing, An T Pham, Victor Khangulov, Randi Fain, Brian H Nathanson, Xuan Zhang, George J Wan, Belinda Lovelace, Jessica Cirillo
Background: Post-surgical pain impacts many patient outcomes. Effective pain management increasingly relies on multimodal analgesia regimens in which acetaminophen (APAP) is a key component. The aim of our study was to examine the impact of oral APAP versus intravenous (IV) APAP as a component of post-surgical pain management after Cesarean sections and hysterectomies. Methods: A retrospective analysis of the Cerner HealthFacts® database (from January, 2011 to December, 2015) was conducted to compare outcomes of Cesarean section and hysterectomy surgery patients who received oral APAP to those who received IV APAP post-surgically...
June 2018: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29629363/pediatric-vital-sign-distribution-derived-from-a-multi-centered-emergency-department-database
#3
Robert J Sepanski, Sandip A Godambe, Arno L Zaritsky
Background: We hypothesized that current vital sign thresholds used in pediatric emergency department (ED) screening tools do not reflect observed vital signs in this population. We analyzed a large multi-centered database to develop heart rate (HR) and respiratory rate centile rankings and z -scores that could be incorporated into electronic health record ED screening tools and we compared our derived centiles to previously published centiles and Pediatric Advanced Life Support (PALS) vital sign thresholds...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29566068/low-serum-sodium-levels-at-hospital-admission-outcomes-among-2-3-million-hospitalized-patients
#4
Saleem Al Mawed, V Shane Pankratz, Kelly Chong, Matthew Sandoval, Maria-Eleni Roumelioti, Mark Unruh
BACKGROUND: Hyponatremia is the most common electrolyte disorder among hospitalized patients. Controversies still exist over the relationship between hyponatremia and outcomes of hospitalized patients. METHODS: To analyze the association of low serum sodium levels at hospital admission with in-hospital mortality and patient disposition and to compare the distribution of the risk of death associated with hyponatremia across the lifespan of hospitalized patients, we conducted an observational study of 2...
2018: PloS One
https://www.readbyqxmd.com/read/29523565/feasibility-of-real-time-capture-of-routine-clinical-data-in-the-electronic-health-record-a-hospital-based-observational-service-evaluation-study
#5
Neil Bodagh, R Andrew Archbold, Roshan Weerackody, Meredith K D Hawking, Michael R Barnes, Aaron M Lee, Surjeet Janjuha, Charles Gutteridge, John Robson, Adam Timmis
OBJECTIVES: The electronic health record (EHR) is underused in the hospital setting. The aim of this service evaluation study was to respond to National Health Service (NHS) Digital's ambition for a paperless NHS by capturing routinely collected cardiac outpatient data in the EHR to populate summary patient reports and provide a resource for audit and research. DESIGN: A PowerForm template was developed within the Cerner EHR, for real-time entry of routine clinical data by clinicians attending a cardiac outpatient clinic...
March 8, 2018: BMJ Open
https://www.readbyqxmd.com/read/29403299/ethnic-racial-differences-in-gastrointestinal-symptoms-and-diagnosis-associated-with-the-risk-of-helicobacter-pylori-infection-in-the-us
#6
Maria-Raquel Huerta-Franco, Julie W Banderas, Jenifer E Allsworth
Background: In the US, neither the prevalence nor the gastrointestinal (GI) diagnosis/symptoms associated with Helicobacter pylori (HP) have been examined in different racial/ethnic groups. Aim: To determine the racial/ethnic differences in HP infection associated with GI diagnoses/symptoms using the Cerner Health Facts® database. Methods: This cross-sectional study collected data during the period of 2000-2015 from the following ethnic/racial groups: 8,236,317 white, 2,085,389 black, 426,622 Hispanic, 293,156 Asian Pacific/Islander (APIs), and 89,179 Native American/Alaskan Native (NA/AN) patients aged 21-65 years old; the data were then analyzed...
2018: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29237956/utility-of-the-laminin-immunohistochemical-stain-in-distinguishing-invasive-from-noninvasive-urothelial-carcinoma
#7
Dinesh Pradhan, Milon Amin, Shveta Hooda, Rajiv Dhir, Sheldon Bastacky, Anil V Parwani
BACKGROUND: To study the utility of the laminin immunostain in distinguishing invasive from noninvasive urothelial carcinoma (UC). The distinction is difficult but clinically significant as it can affect the decision to administer intravesical Bacillus Calmette-Guerin or can even lead to cystectomy. MATERIALS AND METHODS: Representative sections of the transurethral resection of bladder tumor specimens from 25 cases of formalin-fixed paraffin-embedded invasive UCs and 25 cases of noninvasive UCs were selected for immunohistochemical (IHC) staining with laminin (Ventana, Oro Valley, AZ, USA)...
October 2017: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/29181232/machine-learning-to-compare-frequent-medical-problems-of-african-american-and-caucasian-diabetic-kidney-patients
#8
Yong-Mi Kim, Pranay Kathuria, Dursun Delen
Objectives: End-stage renal disease (ESRD), which is primarily a consequence of diabetes mellitus, shows an exemplary health disparity between African American and Caucasian patients in the United States. Because diabetic chronic kidney disease (CKD) patients of these two groups show differences in their medical problems, the markers leading to ESRD are also expected to differ. The purpose of this study was, therefore, to compare their medical complications at various levels of kidney function and to identify markers that can be used to predict ESRD...
October 2017: Healthcare Informatics Research
https://www.readbyqxmd.com/read/29035610/critical-assessment-of-health-disparities-across-subpopulation-groups-through-a-social-determinants-of-health-perspective-the-case-of-type-2-diabetes-patients
#9
Yong-Mi Kim, Dursun Delen
BACKGROUND: Studies on diabetes have shown that population subgroups have varying rates of medical events and related procedures; however, existing studies have investigated either medical events or procedures, and hence, it is unknown whether disparities exist between medical events and procedures. PURPOSE: The objective of this study is to investigate how diabetes-related medical events and procedures are different across population subgroups through a social determinants of health (SDH) perspective...
March 2018: Informatics for Health & Social Care
https://www.readbyqxmd.com/read/28935130/determining-palliative-care-penetration-rates-in-the-acute-care-setting
#10
Heidi Gruhler, April Krutka, Hannah Luetke-Stahlman, Emmie Gardner
CONTEXT: Intermountain Healthcare, in collaboration with Cerner Corporation, developed a hospital-based electronic palliative care algorithm. OBJECTIVES: This study aims to improve identification of patients who would benefit from palliative care services, and calculate palliative care penetration rates. METHODS: This study used a mixed-methods nonrandomized retrospective study design. Three 30-day iterations of clinical data were analyzed for patients identified by the electronic algorithm...
February 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28927349/hospital-readmissions-after-elective-lower-extremity-vascular-procedures
#11
Todd R Vogel, Jamie B Smith, Robin L Kruse
Background This study evaluated risk factors associated with 30-day readmission after open and endovascular lower extremity revascularization. Methods Patients admitted with peripheral artery disease and lower extremity procedures were selected from national electronic medical record data, Cerner Health Facts® (2008-2014). Thirty-day readmission was determined. Logistic regression models identified characteristics independently associated with readmission. Results There were 2781 open and 2611 endovascular procedures...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28823072/prevalence-and-predictors-of-digoxin-utilization-among-heart-failure-patients-with-reduced-ejection-fraction-in-qatar
#12
Alaa Abdullah Rahhal, Ahmed Awaisu, Kawthar M Tawengi, Safae AbuYousef, Lylia Mekideche
Background Digoxin is a cardiac glycoside that is recommended by clinical practice guidelines to be used in patients with heart failure with reduced ejection fraction (HFrEF) who still have persistent symptoms despite optimal medical therapy. However, this recommendation is based on limited and old trial data. Moreover, pharmacoepidemiologic studies are important in determining the prevalence of digoxin use and factors influencing this. Objective This study aimed to determine the prevalence and the predictors of digoxin utilization among patients with HFrEF with or without atrial fibrillation (AF) in Qatar...
October 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28699797/candidemia-and-invasive-candidiasis-among-hospitalized-neonates-and-pediatric-patients
#13
Rachel Harrington, Sylvia L Kindermann, Qingjiang Hou, Robert J Taylor, Nkechi Azie, David L Horn
OBJECTIVE: To investigate the epidemiology, treatment, length of stay (LOS) and costs for neonatal and pediatric inpatients with invasive candidiasis (IC). METHODS: The Cerner Health Facts Database was used to assess inpatients (2005-2014) identified by positive blood or cerebrospinal fluid (CSF) Candida cultures. Log-transformed LOS and cost were examined in candidemia-only patients (n = 191) using multivariable linear regression. RESULTS: A total of 202 patients had a positive culture (blood: n = 192; CSF: n = 10; both: n = 2)...
August 22, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28433336/the-association-of-postoperative-glycemic-control-and-lower-extremity-procedure-outcomes
#14
Todd R Vogel, Jamie B Smith, Robin L Kruse
OBJECTIVE: The effect of postoperative hyperglycemia in patients undergoing open and endovascular procedures on the lower extremities has not been fully characterized with regard to associated admission diagnoses, hospital complications, mortality, and 30-day readmission. This study evaluated the relationship of postoperative hyperglycemia on outcomes after lower extremity vascular procedures for peripheral artery disease. METHODS: Patients with peripheral artery disease admitted for elective lower extremity procedures between September 2008 and March 2014 were selected from the Cerner Health Facts (Cerner Corporation, Kansas City, Mo) database using International Classification of Diseases, Ninth Edition, Clinical Modification diagnosis and procedure codes...
October 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28395891/effect-of-transient-and-sustained-acute-kidney-injury-on-readmissions-in-acute-decompensated-heart-failure
#15
MULTICENTER STUDY
Benjamin J Freda, Alexander B Knee, Gregory L Braden, Paul F Visintainer, Charuhas V Thakar
Although acute kidney injury (AKI) is common in heart failure, yet the impact of the onset, timing, and duration of AKI on short-term outcomes is not well studied. AKI was defined as an increase in serum creatinine SCr of ≥0.3 mg/dl or 1.5 times relative to the admission and further categorized as transient AKI (T-AKI: SCr returning to within 10% of baseline); sustained AKI (S-AKI: those with at least 72 hours of hospital stay and did not meet T-AKI); and unknown duration AKI (U-AKI: those with less than 72 hours stay and did not meet T-AKI)...
June 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28350807/external-validation-and-comparison-of-two-variants-of-the-elixhauser-comorbidity-measures-for-all-cause-mortality
#16
COMPARATIVE STUDY
Yannick Fortin, James A G Crispo, Deborah Cohen, Douglas S McNair, Donald R Mattison, Daniel Krewski
Assessing prevalent comorbidities is a common approach in health research for identifying clinical differences between individuals. The objective of this study was to validate and compare the predictive performance of two variants of the Elixhauser comorbidity measures (ECM) for inhospital mortality at index and at 1-year in the Cerner Health Facts® (HF) U.S. DATABASE: We estimated the prevalence of select comorbidities for individuals 18 to 89 years of age who received care at Cerner contributing health facilities between 2002 and 2011 using the AHRQ (version 3...
2017: PloS One
https://www.readbyqxmd.com/read/28264843/a-risk-score-for-fluconazole-failure-among-patients-with-candidemia
#17
Luis Ostrosky-Zeichner, Rachel Harrington, Nkechi Azie, Hongbo Yang, Nanxin Li, Jing Zhao, Valerie Koo, Eric Q Wu
This study aimed to develop a prediction model to identify patients with candidemia who were at high risk of failing fluconazole treatment. Adult patients in the United States with candidemia who received fluconazole during hospitalization were selected from the Cerner Health Facts Hospital Database (04/2004 to 03/2013). Fluconazole failure was defined as switching/adding another antifungal, positive Candida culture ≥10 days after fluconazole initiation, or death during hospitalization. Patients were randomized into modeling and validation samples...
May 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28211054/real-world-use-of-pomalidomide-and-dexamethasone-in-double-refractory-multiple-myeloma-suggests-benefit-in-renal-impairment-and-adverse-genetics-a-multi-centre-uk-experience
#18
Nicola Maciocia, Andrew Melville, Simon Cheesman, Faye Sharpley, Karthik Ramasamy, Matthew Streetly, Matthew Jenner, Reuben Benjamin, Steve Schey, Paul Maciocia, Rakesh Popat, Shirley D'sa, Ali Rismani, Aviva Cerner, Kwee Yong, Neil Rabin
Myeloma patients who become refractory to immunomodulatory agents (IMiDs) and bortezomib have poor survival, with limited therapeutic options. Pomalidomide has shown improved survival and good tolerability in this patient cohort in clinical trials, but real world data are scarce. We retrospectively analysed all patients treated with pomalidomide at five UK centres between 2013 and 2016. Of 85 patients identified, 70 had sufficient information for response assessments. Median age was 66 years [40-89], 96·5% were refractory to IMiDs, 72·9% were refractory to both an IMiD and bortezomib and 92·9% were refractory to their last treatment...
March 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28177854/risk-factors-for-30-day-hospital-re-admission-with-an-infectious-complication-after-lower-extremity-vascular-procedures
#19
Joseph C Melvin, Jamie B Smith, Robin L Kruse, Todd R Vogel
BACKGROUND: Lowering the 30-d re-admission rate after vascular surgery offers the potential to improve healthcare quality. This study evaluated re-admission associated with infections after open and endovascular lower extremity (LE) procedures for peripheral artery disease (PAD). METHODS: Patients admitted for elective LE procedures for PAD were selected from the Cerner Health Facts® database. Chi-square analysis evaluated the characteristics of the index admission associated with infection at 30-d re-admission...
April 2017: Surgical Infections
https://www.readbyqxmd.com/read/28060831/using-automated-hba1c-testing-to-detect-diabetes-mellitus-in-orthopedic-inpatients-and-its-effect-on-outcomes
#20
Elif I Ekinci, Alvin Kong, Leonid Churilov, Natalie Nanayakkara, Wei Ling Chiu, Priya Sumithran, Frida Djukiadmodjo, Erosha Premaratne, Elizabeth Owen-Jones, Graeme Kevin Hart, Raymond Robbins, Andrew Hardidge, Douglas Johnson, Scott T Baker, Jeffrey D Zajac
AIMS: The prevalence of diabetes is rising, and people with diabetes have higher rates of musculoskeletal-related comorbidities. HbA1c testing is a superior option for diabetes diagnosis in the inpatient setting. This study aimed to (i) demonstrate the feasibility of routine HbA1c testing to detect the presence of diabetes mellitus, (ii) to determine the prevalence of diabetes in orthopedic inpatients and (iii) to assess the association between diabetes and hospital outcomes and post-operative complications in orthopedic inpatients...
2017: PloS One
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