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https://www.readbyqxmd.com/read/28812150/respiratory-complications-after-colonic-procedures-in-chronic-obstructive-pulmonary-disease-does-laparoscopy-offer-a-benefit
#1
Sarath Sujatha-Bhaskar, Reza Fazl Alizadeh, Colette S Inaba, Christina Y Koh, Mehraneh D Jafari, Steven D Mills, Joseph C Carmichael, Michael J Stamos, Alessio Pigazzi
BACKGROUND: Patients with severe chronic obstructive pulmonary disease (COPD) are at a higher risk for postoperative respiratory complications. Despite the benefits of a minimally invasive approach, laparoscopic pneumoperitoneum can substantially reduce functional residual capacity and raise alveolar dead space, potentially increasing the risk of respiratory failure which may be poorly tolerated by COPD patients. This raises controversy as to whether open techniques should be preferentially employed in this population...
August 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28812025/baseline-characteristics-of-the-paediatric-observation-priority-score-in-emergency-departments-outside-its-centre-of-derivation
#2
Damian Roland, Fawaz Arshad, Tim Coats, Ffion Davies
OBJECTIVES AND BACKGROUND: Scoring systems in Emergency Departments (EDs) are rarely validated. This study aimed to examine the Paediatric Observation Priority Score (POPS), a method of quantifying patient acuity, in EDs in the United Kingdom, and determine baseline performance characteristics. METHODS: POPS was implemented in 4 EDs for children (ages of 0 to 16) with participants grouped into 3 categories: discharged from ED, discharged but with return within 7 days, and admitted for less or more than 24 hours...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28811986/elderly-age-as-a-risk-factor-for-30-day-postoperative-outcomes-following-elective-anterior-cervical-discectomy-and-fusion
#3
John Di Capua, Sulaiman Somani, Jun S Kim, Kevin Phan, Nathan J Lee, Parth Kothari, Samuel K Cho
STUDY DESIGN: Retrospective analysis of prospectively collected data. OBJECTIVE: Anterior cervical discectomy and fusion (ACDF) is one of the most commonly performed spinal procedures. Considering the high success and low complications rate of ACDF and high prevalence of age-related degeneration of the cervical spine, the rates of ACDF are expected to continually rise. The objective is to identify the association between patient age and 30-day postoperative outcomes following elective ACDF...
August 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28811982/a-matched-cohort-analysis-comparing-stand-alone-cages-and-anterior-cervical-plates-used-for-anterior-cervical-discectomy-and-fusion
#4
Samuel C Overley, Robert K Merrill, Dante M Leven, Joshua J Meaike, Abhishek Kumar, Sheeraz A Qureshi
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To compare perioperative characteristics of stand-alone cages and anterior cervical plates used for anterior cervical discectomy and fusion (ACDF). METHODS: We reviewed 40 adult patients who received a stand-alone cage for elective ACDF and matched them with 40 patients who received an anterior cervical plate. We statistically compared operative time, length of stay, proportion of ambulatory cases, overall complications necessitating a trip to the ED, readmission, or reoperation related to index procedure...
August 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28811042/understanding-readmissions-in-children-undergoing-surgery-a-pediatric-nsqip-analysis
#5
Afif N Kulaylat, Dorothy V Rocourt, Anthony Y Tsai, Kathryn L Martin, Brett W Engbrecht, Mary C Santos, Robert E Cilley, Christopher S Hollenbeak, Peter W Dillon
BACKGROUND: Readmission is increasingly being utilized as an important clinical outcome and measure of hospital quality. Our aim was to delineate rates, risk factors, and reasons for unplanned readmission in pediatric surgery. MATERIALS AND METHODS: Retrospective review of pediatric patients (n=130,274) undergoing surgery (2013-2014) at hospitals enrolled in the Pediatric National Surgical Quality Improvement Program (NSQIP-P) was performed. Logistic regression was used to model factors associated with unplanned 30-day readmission...
July 31, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28810888/hospitalisation-in-an-emergency-department-short-stay-unit-compared-to-an-internal-medicine-department-is-associated-with-fewer-complications-in-older-patients-an-observational-study
#6
Camilla Strøm, Talie Khadem Mollerup, Laurits Schou Kromberg, Lars Simon Rasmussen, Thomas Andersen Schmidt
BACKGROUND: Older patients are at particular risk of experiencing adverse events during hospitalisation. OBJECTIVE: To compare the frequencies and types of adverse events during hospitalisation in older persons acutely admitted to either an Emergency Department Short-stay Unit (SSU) or an Internal Medicine Department (IMD). METHODS: Observational study evaluating adverse events during hospitalisation in non-emergent, age-matched, internal medicine patients ≥75 years, acutely admitted to either the SSU or the IMD at Holbaek Hospital, Denmark, from January to August, 2014...
August 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28810640/in-hospital-and-long-term-outcomes-of-congestive-heart-failure-predictive-value-of-b-type-and-amino-terminal-pro-b-type-natriuretic-peptides-and-their-ratio
#7
Yuxiang Dai, Jun Yang, Atsutoshi Takagi, Hakuoh Konishi, Tetsuro Miyazaki, Hiroshi Masuda, Kazunori Shimada, Katsumi Miyauchi, Hiroyuki Daida
Relative changes in B-type natriuretic peptide (BNP) and amino terminal pro-BNP (NT-proBNP) levels may help to assess the risk of congestive heart failure (CHF). However, whether these levels at the time of admission enable the prediction of outcomes with acute exacerbation remains unknown. The current study determined the abilities of BNP, NT-proBNP and their ratio to predict in-hospital and long-term outcomes of patients with CHF. Patients who were admitted to the cardiac care unit of Juntendo University Hospital (Tokyo, Japan) with acute CHF onset were consecutively enrolled into the present observational study...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28808930/hospitalization-in-the-year-preceding-major-oncologic-surgery-increases-risk-for-adverse-postoperative-events
#8
Catherine E Sharoky, Karole T Collier, Christopher J Wirtalla, Andrew J Sinnamon, Madalyn G Neuwirth, Lindsay E Kuo, Robert E Roses, Douglas L Fraker, Giorgos C Karakousis, Rachel R Kelz
BACKGROUND: Hospitalization is associated with negative clinical effects that last beyond discharge. This study aimed to determine whether hospitalization in the year before major oncologic surgery is associated with adverse outcomes. METHODS: Patients 18 years of age or older with stomach, pancreas, colon, or rectal cancer who underwent resection in California and New York (2008-2010) were included in the study. Patients with hospitalization in the year prior to oncologic resection (HYPOR) were identified...
August 14, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28808884/outcomes-of-laparoscopic-hiatal-hernia-repair-in-nine-bariatric-patients-with-prior-sleeve-gastrectomy
#9
Francisco Igor B Macedo, Mia Mowzoon, Vijay K Mittal, Mubashir Sabir
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) may exacerbate gastroesophageal reflux disease (GERD) in patients with a hiatal hernia (HH). Surgical repair may be needed, however prior LSG precludes standard HH repair with fundoplication. METHODS: We retrospectively reviewed our experience with bariatric patients with prior LSG undergoing laparoscopic HH repair from August 2010 to July 2016. Patient demographics and outcomes including mortality, length of stay (LOS), readmission rates, reoperation, and complications were described...
August 14, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28808868/effect-of-multimodal-analgesia-on-opioid-use-after-open-ventral-hernia-repair
#10
Jeremy A Warren, Caroline Stoddard, Ahan L Hunter, Anthony J Horton, Carlyn Atwood, Joseph A Ewing, Steven Pusker, Vito A Cancellaro, Kevin B Walker, William S Cobb, Alfredo M Carbonell, Robert R Morgan
BACKGROUND: There is limited data on enhanced recovery after surgery (ERAS) protocols after ventral hernia repair (VHR). This study reports the impact of multimodal analgesia on opioid use after open VHR. METHODS: Retrospective review of open VHR treated during the initial 6 months after ERAS implementation. Protocol focused on opioid sparing using intraoperative ketamine and/or lidocaine infusion, selective epidural anesthesia, and postoperative ketamine infusion, ketorolac, and acetaminophen...
August 14, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28807692/community-use-of-physical-and-occupational-therapy-after-stroke-and-risk-of-hospital-readmission
#11
Janet K Freburger, Dongmei Li, Erin P Fraher
OBJECTIVES: To determine whether receipt of therapy and number and timing of therapy visits decreased hospital readmission risk in stroke survivors discharged home. DESIGN: Retrospective cohort analysis of Medicare claims (2010-2013). SETTING: Acute care hospital and community. PARTICIPANTS: Patients hospitalized for stroke who were discharged home and survived the first 30 days (N=23,413; mean [SD] age of 77.6 [7.5] years)...
August 11, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28807639/a-survey-of-caesarean-section-surgical-site-infections-with-pico%C3%A2-single-use-negative-pressure-wound-therapy-system-in-high-risk-patients-in-england-and-ireland
#12
R J Searle, D Myers
This article reports audit data from the introduction of the PICO™ System for caesarean section patients with high body mass index (BMI) in four hospitals in the UK and Ireland. PICO was used on closed surgical incisions following caesarean section in 399 patients with BMI ≥35kg/m(2). Thirty-six out of 399 patients (9.0%) developed signs of surgical site infection (SSI), a rate lower than a previously reported incidence of 19.3% in a similar population. The readmission incidence was 0.8%. Therefore the use of PICO on closed surgical incisions may be associated with low incidence of SSI and readmission in this high-risk group...
August 11, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28807456/post-hospitalization-experiences-of-older-adults-diagnosed-with-diabetes-it-was-daunting
#13
Jacqueline B La Manna, Angeline Bushy, Denise Gammonley
Multimorbidity combined with geriatric syndromes in older adults with diabetes exacerbate their risks for poor post-discharge outcomes. The purpose of this study was to examine self-described hospital-to-home transition challenges encountered by older adults with a diagnosis of diabetes within the first 30 days following discharge. The qualitative responses for this paper emerged from a larger mixed methods study (n = 96) in which participants provided free responses specifying transition challenges during follow-up telephone interviews on the 7th day (n = 67) and 30th day (n = 55) post-discharge...
August 11, 2017: Geriatric Nursing
https://www.readbyqxmd.com/read/28807254/minimally-invasive-gastrectomy-for-gastric-cancer-a-national-perspective-on-oncologic-outcomes-and-overall-survival
#14
Kenneth Leung, Zhifei Sun, Daniel P Nussbaum, Mohamed A Adam, Mathias Worni, Dan G Blazer
BACKGROUND: Minimally invasive (MI) gastrectomy has become increasingly common as a resection technique for gastric cancer; however, data are limited regarding peri-operative morbidity, oncologic outcomes and long-term survival, particularly in the Western patient population. STUDY DESIGN: The 2010-2012 National Cancer Data Base was queried for adult patients who underwent gastrectomy for localized, intestinal-type gastric adenocarcinoma. Patients were classified by surgical approach (MI vs...
September 2017: Surgical Oncology
https://www.readbyqxmd.com/read/28806942/impact-of-inpatient-care-in-emergency-department-on-outcomes-a-quasi-experimental-cohort-study
#15
Aisha Lateef, Soo Hoon Lee, Dale Andrew Fisher, Wei-Ping Goh, Hui Fen Han, Uma Chandra Segara, Tiong Beng Sim, Malcolm Mahadehvan, Khean Teik Goh, Noel Cheah, Aymeric Yt Lim, Phillip H Phan, Reshma A Merchant
BACKGROUND: Hospitals around the world are faced with the issue of boarders in emergency department (ED), patients marked for admission but with no available inpatient bed. Boarder status is known to be associated with delayed inpatient care and suboptimal outcomes. A new care delivery system was developed in our institution where boarders received full inpatient care from a designated medical team, acute medical team (AMT), while still residing at ED. The current study examines the impact of this AMT intervention on patient outcomes...
August 14, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28806793/holding-providers-accountable-for-health-care-outcomes
#16
David W Baker, Mark R Chassin
Federal public reporting and payment programs have increasingly emphasized the measurement of outcomes (such as readmission, health care-associated infections, and mortality). Yet, the criteria for assessing whether outcome measures are accurate and valid enough to use for public reporting, payment, and accreditation are not well-defined. An outcome measure should be used only if the outcome can be influenced substantially by providers (that is, a strong process-outcome link exists) and statistical adjustment can be made for differences in patient populations across providers so that differences in outcomes are truly attributable to differences in the care provided...
August 15, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28806283/expanding-the-scope-of-quality-measurement-in-surgery-to-include-non-operative-care-results-from-the-acs-nsqip-emergency-general-surgery-pilot
#17
Michael W Wandling, Clifford Y Ko, Paul E Bankey, Chris Cribari, H Gill Cryer, Jose J Diaz, Therese M Duane, S Morad Hameed, Matthew M Hutter, Michael H Metzler, Justin L Regner, Patrick M Reilly, H David Reines, Jason L Sperry, Kristan L Staudenmayer, Garth H Utter, Marie L Crandall, Karl Y Bilimoria, Avery B Nathens
BACKGROUND: Patients managed non-operatively have been excluded from risk-adjusted benchmarking programs, including the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP). Consequently, optimal performance evaluation is not possible for specialties like emergency general surgery (EGS) where non-operative management is common. We developed a multi-institutional EGS clinical data registry within ACS NSQIP that includes patients managed non-operatively to evaluate variability in non-operative care across hospitals and identify gaps in performance assessment that occur when only operative cases are considered...
August 12, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28805599/nationwide-trends-and-in-hospital-complications-of-trachelectomy-for-surgically-resectable-cervical-cancer-in-taiwanese-women-a%C3%A2-population-based-study-1998-2013
#18
Jerry Cheng-Yen Lai, Hung-Hui Chen, Kuei-Hui Chu, Chia-Sui Weng, Yiing-Jenq Chou, Nicole Huang, Yu-Ju Chien, Kung-Liahng Wang
OBJECTIVE: To describe the nationwide trends in the utilization of trachelectomy among Taiwanese women with surgically resectable cervical cancer over the past decade, and to compare associated demographic characteristics, in-hospital complications and related outcomes using a population-based dataset from 1998 to 2013. MATERIALS AND METHODS: We conducted a population-based, cohort study using inpatient admission claims data of Taiwan's National Health Insurance program...
August 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28805361/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-the-long-term-care-hospital-prospective-payment-system-and-policy-changes-and-fiscal-year-2018-rates-quality-reporting-requirements-for-specific-providers-medicare
#19
(no author information available yet)
We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2018. Some of these changes implement certain statutory provisions contained in the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Medicare Access and CHIP Reauthorization Act of 2015, the 21st Century Cures Act, and other legislation...
August 14, 2017: Federal Register
https://www.readbyqxmd.com/read/28805345/laparoscopic-sleeve-gastrectomy-improves-renal-transplant-candidacy-and-post-transplant-outcomes-in-morbidly-obese-patients
#20
Y Kim, A D Jung, V K Dhar, J S Tadros, D P Schauer, E P Smith, D J Hanseman, M C Cuffy, R R Alloway, A R Shields, S A Shah, E S Woodle, T S Diwan
Morbid obesity is a barrier to KT due to inferior outcomes, including higher rates of new-onset diabetes after transplantation (NODAT), delayed graft function (DGF), and graft failure. LSG increases transplant eligibility by reducing body mass index (BMI) in KT candidates, but the effect of surgical weight loss on post-transplant outcomes is unknown. Reviewing single-center medical records, we identified all patients who underwent LSG prior to KT from 2011-2016 (n=20). Post-LSG kidney recipients were compared with similar-BMI recipients who did not undergo LSG, using 2:1 direct matching for patient factors...
August 14, 2017: American Journal of Transplantation
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