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https://www.readbyqxmd.com/read/28161983/prospective-correlates-of-early-30%C3%A2-day-readmissions-on-a-cardiothoracic-surgery-service
#1
Mark W Ketterer, Mansi Chawa, Gaetano Paone
Known to vary widely among hospitals for unclear reasons, early readmissions are associated with higher mortality and are suspected to frequently be due to inadequate discharge preparation/planning. It has been previously documented that the strongest and most consistent predictor of early readmissions in CHF patients is chronic cognitive impairment, and compensatory assistance with adherence on discharge improves early readmission rates. Prospective observational study. The present investigation examined multiple putative perioperative predictors of early readmission in a hospitalized Cardiothoracic Surgery Service...
February 6, 2017: Psychology, Health & Medicine
https://www.readbyqxmd.com/read/28159650/impact-of-the-new-kidney-allocation-system-on-perioperative-outcomes-and-costs-in-kidney-transplantation
#2
David J Taber, Derek DuBay, John W McGillicuddy, Satish Nadig, Charles F Bratton, Kenneth D Chavin, Prabhakar K Baliga
BACKGROUND: In December 2014, a new kidney allocation system (KAS) was implemented nationwide with the goal of improving longevity matching, increasing access to sensitized patients, and improving racial/ethnic disparities. STUDY DESIGN: National cohort study of US kidney transplantation programs, analyzing hospital-level outcomes (October 2012 to June 2016) using University HealthSystem Consortium data. In-hospital outcomes and costs were analyzed for trends over time using interrupted time series analysis with segmented regression...
January 31, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28153458/ten-year-trends-and-independent-risk-factors-for-unplanned-readmission-following-elective-total-joint-arthroplasty-at-a-large-urban-academic-hospital
#3
Matthew A Varacallo, Leah Herzog, Nader Toossi, Norman A Johanson
BACKGROUND: Total joint arthroplasty procedures continue to provide consistent, long-term success and high patient satisfaction scores. However, early unplanned readmission to the hospital imparts significant financial risks to individual institutions as we shift away from the traditional fee-for-service payment model. METHODS: Using a combination of our hospital's administrative database and retrospective chart reviews, we report the 30-day and 90-day readmission rates and all causes of readmission following all unilateral, primary elective total hip and knee arthroplasty procedures at a large, urban, academic hospital from 2004 to 2013...
December 27, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28126175/risk-factors-for-30-day-unplanned-readmission-following-infrainguinal-endovascular-interventions
#4
Thomas C F Bodewes, Peter A Soden, Klaas H J Ultee, Sara L Zettervall, Alexander B Pothof, Sarah E Deery, Frans L Moll, Marc L Schermerhorn
OBJECTIVE: Unplanned hospital readmissions following surgical interventions are associated with adverse events and contribute to increasing health care costs. Despite numerous studies defining risk factors following lower extremity bypass surgery, evidence regarding readmission after endovascular interventions is limited. This study aimed to identify predictors of 30-day unplanned readmission following infrainguinal endovascular interventions. METHODS: We identified all patients undergoing an infrainguinal endovascular intervention in the targeted vascular module of the American College of Surgeons National Surgical Quality Improvement Program between 2012 and 2014...
February 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28100157/characterization-of-planned-and-unplanned-30-day-readmissions-following-vascular-surgical-procedures
#5
Georges Tahhan, Alik Farber, Nishant K Shah, Brianna M Krafcik, Teviah E Sachs, Jeffrey A Kalish, Matthew R Peacock, Jeffrey J Siracuse
OBJECTIVE: Thirty-day readmission is increasingly used as a quality of care indicator. Patients undergoing vascular surgery have historically been at high risk for readmission. We analyzed hospital readmission details to identify patients at high risk for readmission in order to better understand these readmissions and improve resource utilization in this patient population. METHODS: A retrospective review and analysis of our medical center's admission and discharge data were conducted from October 2012 to March 2015...
January 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28079709/meaningful-use-of-electronic-health-records-by-outpatient-physicians-and-readmissions-of-medicare-fee-for-service-beneficiaries
#6
Mark A Unruh, Hye-Young Jung, Joshua R Vest, Lawrence P Casalino, Rainu Kaushal
BACKGROUND: Nearly one-fifth of hospitalized Medicare fee-for-service beneficiaries are readmitted within 30 days. Participation in the Meaningful Use initiative among outpatient physicians may reduce readmissions. OBJECTIVE: To evaluate the impact of outpatient physicians' participation in Meaningful Use on readmissions. SUBJECTS AND RESEARCH DESIGN: The study population included 90,774 Medicare fee-for-service beneficiaries from New York State (2010-2012)...
January 10, 2017: Medical Care
https://www.readbyqxmd.com/read/28055049/clinical-outcomes-of-metformin-use-in-populations-with-chronic-kidney-disease-congestive-heart-failure-or-chronic-liver-disease-a-systematic-review
#7
Matthew J Crowley, Clarissa J Diamantidis, Jennifer R McDuffie, C Blake Cameron, John W Stanifer, Clare K Mock, Xianwei Wang, Shuang Tang, Avishek Nagi, Andrzej S Kosinski, John W Williams
Background: Recent changes to the U.S. Food and Drug Administration boxed warning for metformin will increase its use in persons with historical contraindications or precautions. Prescribers must understand the clinical outcomes of metformin use in these populations. Purpose: To synthesize data addressing outcomes of metformin use in populations with type 2 diabetes and moderate to severe chronic kidney disease (CKD), congestive heart failure (CHF), or chronic liver disease (CLD) with hepatic impairment...
February 7, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28054808/cognitive-impairment-in-heart-failure-a-protective-role-for-angiotensin-1-7
#8
Meredith Hay, Todd W Vanderah, Farmin Samareh-Jahani, Eleni Constantopoulos, Ajay R Uprety, Carol A Barnes, John Konhilas
Patients with congestive heart failure (CHF) have increased hospital readmission rates and mortality if they are concomitantly diagnosed with cognitive decline and memory loss. Accordingly, we developed a preclinical model of CHF-induced cognitive impairment with the goal of developing novel protective therapies against CHF related cognitive decline. CHF was induced by ligation of the left coronary artery to instigate a myocardial infarction (MI). By 4- and 8-weeks post-MI, CHF mice had approximately a 50% and 70% decline in ejection fraction as measured by echocardiography...
February 2017: Behavioral Neuroscience
https://www.readbyqxmd.com/read/28024302/readmission-rates-after-passage-of-the-hospital-readmissions-reduction-program-a-pre-post-analysis
#9
Jason H Wasfy, Corwin Matthew Zigler, Christine Choirat, Yun Wang, Francesca Dominici, Robert W Yeh
Background: Whether hospitals with the highest risk-standardized readmission rates (RSRRs) subsequently experienced the greatest improvement after passage of the Medicare Hospital Readmissions Reduction Program (HRRP) is unknown. Objective: To evaluate whether passage of the HRRP was followed by acceleration in improvement in 30-day RSRRs after hospitalizations for acute myocardial infarction (AMI), congestive heart failure (CHF), or pneumonia and whether the lowest-performing hospitals had faster acceleration in improvement after passage of the law than hospitals that were already performing well...
December 27, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27927839/does-medicare-advantage-reduce-racial-disparity-in-30-day-rehospitalization-for-medicare-beneficiaries
#10
Yue Li, Xi Cen, Xueya Cai, Dongliang Wang, Caroline Pinto Thirukumaran, Laurent G Glance
This study determined potential racial and ethnic disparities in risk for all-cause 30-day readmission among traditional Medicare (TM) and Medicare Advantage (MA) beneficiaries initially hospitalized for acute myocardial infarction, congestive heart failure, or pneumonia. Our analyses of New York State hospital administrative data between 2009 and 2012 found that overall 30-day readmission rate declined from 22.0% in 2009 to 20.7% in 2012 for TM beneficiaries, and from 20.2% in 2009 to 17.9% in 2012 for MA beneficiaries...
December 6, 2016: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/27866034/micro-vs-macrodiscectomy-does-use-of-the-microscope-reduce-complication-rates
#11
Meghan E Murphy, Jeffrey S Hakim, Panagiotis Kerezoudis, Mohammed Ali Alvi, Daniel S Ubl, Elizabeth B Habermann, Mohamad Bydon
OBJECTIVE: A single level discectomy is one of the most common procedures performed by spine surgeons. While some practitioners utilize the microscope, others do not. We postulate improved visualization with an intraoperative microscope decreases complications and inferior outcomes. METHODS: A multicenter surgical registry was utilized for this retrospective cohort analysis. Patients with degenerative spinal diagnoses undergoing elective single level discectomies from 2010 to 2014 were included...
January 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/27856785/chronic-obstructive-pulmonary-disease-phenotypes-using-cluster-analysis-of-electronic-medical-records
#12
Rodrigo Vazquez Guillamet, Oleg Ursu, Gary Iwamoto, Pope L Moseley, Tudor Oprea
Chronic obstructive pulmonary disease is a heterogeneous disease. In this retrospective study, we hypothesize that it is possible to identify clinically relevant phenotypes by applying clustering methods to electronic medical records. We included all the patients >40 years with a diagnosis of chronic obstructive pulmonary disease admitted to the University of New Mexico Hospital between 1 January 2011 and 1 May 2014. We collected admissions, demographics, comorbidities, severity markers and treatments...
November 17, 2016: Health Informatics Journal
https://www.readbyqxmd.com/read/27854123/a-retrospective-analysis-of-cardiovascular-outcomes-in-patients-treated-with-asv
#13
Arild Hetland, Kristina H Haugaa, Maria Vistnes, Kristian Hovde Liland, Margareth Olseng, Morten B Jacobsen, Thor Edvardsen
OBJECTIVES: The effect of long-term adaptive servo-ventilation (ASV) on cardiovascular mortality and admission rates in patients with chronic heart failure (CHF) and Cheyne-Stokes respiration (CSR) has not been much studied. The aim of this study was primarily to investigate whether ASV therapy significantly reduced these parameters. DESIGN: We included 75 CHF patients on optimal medication and CSR ≥25% of sleeping time, in New York Heart Association (NYHA) classes II-IV and left ventricular ejection fraction (LVEF) ≤ 45%...
December 7, 2016: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/27824514/30-day-readmission-rates-in-patients-admitted-for-heart-failure-exacerbation-with-and-without-palliative-care-consultation-a-retrospective-cohort-study
#14
Elizabeth Chuang, Gina Kim, Arthur E Blank, William Southern, James Fausto
BACKGROUND: Palliative care consultation improves quality of care through symptom management, communication, care coordination, and earlier hospice referral, and it may decrease burdensome hospital readmissions at the end of life. OBJECTIVES: To compare 30-day readmission rates for patients admitted with exacerbation of congestive heart failure (CHF) receiving palliative care consultation services compared with controls. DESIGN: Retrospective cohort study using propensity score matching...
February 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27713623/patterns-of-scheduled-follow-up-appointments-following-hospitalization-for-heart-failure-insights-from-an-urban-medical-center-in-the-united-states
#15
Parag Goyal, Madeline R Sterling, Ashley N Beecy, John T Ruffino, Sonal S Mehta, Erica C Jones, Mark S Lachs, Evelyn M Horn
OBJECTIVES: Although postdischarge outpatient follow-up appointments after a hospitalization for heart failure represent a potentially effective strategy to prevent heart failure readmissions, patterns of scheduled follow-up appointments upon discharge are poorly described. We aimed to characterize real-world patterns of scheduled follow-up appointments among adult patients with heart failure upon hospital discharge. PATIENTS AND METHODS: This was a retrospective cohort study performed at a large urban academic center in the United States among adults hospitalized with a principal diagnosis of congestive heart failure between January 1, 2013, and December 31, 2014...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27692135/evaluation-of-chronic-obstructive-pulmonary-disease-copd-and-reduced-ejection-fraction-heart-failure-hrref-discharge-medication-prescribing-is-drug-therapy-concordant-with-national-guidelines-associated-with-a-reduction-in-30-day-readmissions
#16
Amy Richardson, Elizabeth Tolley, Jonathan Hartmann, Jasmine Reedus, Brandi Bowlin, Christopher Finch, Christopher W Sands, Timothy Self
INTRODUCTION: Approximately 1 in 5 hospitalized COPD patients are readmitted within 30 days of discharge. CHF coexists in more than 20% of patients with COPD, and is associated with early readmission for COPD. Reducing 30-day hospital readmissions for COPD is of intense current interest. METHODOLOGY: A retrospective chart review was performed to identify patients discharged with COPD exacerbation and HFrEF. The primary objective was to evaluate if discharge medication prescribing following guidelines for both COPD and HFrEF correlates with reduced 30-day readmission rates...
October 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27664509/a-mixed-ensemble-model-for-hospital-readmission
#17
Lior Turgeman, Jerrold H May
OBJECTIVE: A hospital readmission is defined as an admission to a hospital within a certain time frame, typically thirty days, following a previous discharge, either to the same or to a different hospital. Because most patients are not readmitted, the readmission classification problem is highly imbalanced. MATERIALS AND METHODS: We developed a hospital readmission predictive model, which enables controlling the tradeoff between reasoning transparency and predictive accuracy, by taking into account the unique characteristics of the learned database...
September 2016: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/27625407/predictors-of-rehospitalization-among-adults-with-congenital-heart-disease-are-lesion-specific
#18
Ari M Cedars, Sara Burns, Eric L Novak, Amit P Amin
BACKGROUND: Readmission is responsible for a large proportion of inpatient care costs in adult congenital heart disease. There are, however, few data available to identify at-risk patients or to suggest strategies for intervention to prevent rehospitalization. METHODS AND RESULTS: We conducted an analysis of admissions in patients over the age of 18 years with a 3-digit International Classification of Diseases-Ninth Revision code of 745 to 747 from the State Inpatient Databases of Arkansas (2008-2010), California (2003-2012), Florida (2005-2012), Hawaii (2006-2010), Nebraska (2003-2011), and New York (2005-2012)...
September 2016: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/27581675/tolvaptan-improves-the-long-term-prognosis-in-patients-with-congestive-heart-failure-with-preserved-ejection-fraction-as-well-as-in-those-with-reduced-ejection-fraction
#19
Teruhiko Imamura, Koichiro Kinugawa
Tolvaptan (TLV), an arginine vasopressin type 2 antagonist, has been shown to play a role in ameliorating symptomatic congestion and normalizing diluted hyponatremia in patients with congestive heart failure (HF). However, most evidence was derived from patients with HF with reduced ejection fraction (HFrEF), and the clinical efficacy of TLV in patients with HF with preserved ejection fraction (HFpEF) remains uncertain. In this study, we retrospectively enrolled 60 in-hospital patients with stage D HF, who had received TLV to treat symptomatic congestion at our institute between 2011 and 2013...
September 28, 2016: International Heart Journal
https://www.readbyqxmd.com/read/27524216/morbidity-and-mortality-of-congestive-heart-failure-in-trauma-patients
#20
Hassan Alkhawam, Raef Madanieh, Mohammed El-Hunjul, Abed Madanieh, Umer Syed, Sumair Ahmad, Joseph J Lieber, Timothy J Vittorio
BACKGROUND: Cardiovascular morbidity and mortality in heart failure (HF) patients comprise a major health and economic burden, especially when readmission rate and length of stay (LOS) are considered. With increasing average life expectancy, HF prevalence continues to rise. Diseases such as diabetes mellitus, hypertension and ischemic heart disease continue to be the leading causes of HF. Current data suggest that HF is the most common cause for hospital admission in patients older than 65 years...
August 2016: American Journal of the Medical Sciences
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