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https://www.readbyqxmd.com/read/28944935/models-to-predict-readmission-rates-trying-to-sand-the-wings-of-the-boomerang
#1
Thomas Münzer
No abstract text is available yet for this article.
September 25, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28944725/intermediate-risk-of-cardiac-events-and-recurrent-stroke-after-stroke-admission-in-young-adults
#2
Peter Jin, Ivan Matos Diaz, Laura Stein, Alison Thaler, Stanley Tuhrim, Mandip S Dhamoon
Background In older adults with stroke, there is an increased risk of cardiovascular events in the intermediate period, up to one year after stroke. The risk of cardiovascular events in this period in young adults after stroke has not been studied. We hypothesized that in the intermediate risk period, young adults with ischemic stroke have an increased risk of recurrent stroke and a smaller increase of cardiac events. Methods Using the National Readmissions Database during the year 2013, we identified ischemic stroke admissions among those aged 18-45 years using International Classification of Disease, Ninth Revision, Clinical Modification codes to identify index vascular events and risk factors...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28944074/an-educational-tool-for-the-prophylaxis-of-hepatic-encephalopathy
#3
Maria Garrido, Matteo Turco, Chiara Formentin, Michela Corrias, Michele De Rui, Sara Montagnese, Piero Amodio
BACKGROUND: Providing structured information for the understanding of hepatic encephalopathy (HE) might be relevant to the prevention and management of the syndrome. The aim of our study was to design a brief, structured educational intervention and evaluate its usefulness in preventing HE-related hospitalisation over time. METHODS: Thirty-nine cirrhotic outpatients with a history of HE were enrolled and randomly assigned to an intervention (group A; n=20) or control group (group B; n=19)...
2017: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/28943912/effect-of-hospital-to-home-nutrition-management-model-on-postoperative-clinical-outcomes-of-patients-with-laryngeal-carcinoma
#4
Guihua Song, Haizhen Liu
The purpose of this investigation was to determine the effectiveness of a Hospital to Home (H2H) nutrition management model on the postoperative clinical outcomes of patients with laryngeal carcinoma. Eighty-six patients with laryngeal carcinoma were randomly divided into an observation (H2H nutrition management) or control group (routine nutrition management). The ratios of urine lactulose to mannitol (L/M) in serum orexin-A levels of patients in both groups on the 1st postoperative day were significantly higher than before surgery; these levels decreased from the 7th and 14th postoperative day, but remained higher than before surgery (p<0...
October 2017: Oncology Letters
https://www.readbyqxmd.com/read/28943213/evaluating-the-feasibility-of-phrenoesophagopexy-during-hiatal-hernia-repair-in-sleeve-gastrectomy-patients
#5
Nathaniel R Ellens, Joshua E Simon, Kimberly D Kemmeter, Tyler W Barreto, Paul R Kemmeter
BACKGROUND: Both hiatal hernias (HH) and morbid obesity significantly contribute to gastroesophageal reflux disease, which increases the risk for esophagitis and esophageal cancer. Therefore, concomitant HH repair is recommended during bariatric surgery procedures. Unfortunately, recurrence of HH after repair is not uncommon and the optimal surgical technique has yet to be established. OBJECTIVE: To evaluate the feasibility of recreating the phrenoesophageal ligaments by adding phrenoesophagopexy to HH repair during sleeve gastrectomy...
August 26, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28943178/factors-associated-with-degree-of-tumour-response-to-neo-adjuvant-radiotherapy-in-rectal-cancer-and-subsequent-corresponding-outcomes
#6
K J Gash, O Baser, R P Kiran
BACKGROUND: Tumour response to neo-adjuvant radiotherapy for rectal cancer varies significantly between patients, as classified by Tumour Regression Grade (TRG 0-3), with 0 equating to pathological complete response (pCR) and 3 denoting minimal/no response. pCR is associated with significantly better local recurrence rates and survival, but is achieved in only 20-30% of patients. The literature contains limited data reporting factors predictive of tumour response and corresponding outcomes according to degree of regression...
August 10, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28943140/hospital-to-home-a-quality-improvement-initiative-to-implement-high-fidelity-simulation-training-for-caregivers-of-children-requiring-long-term-mechanical-ventilation
#7
Jodi Thrasher, Joyce Baker, Kathleen M Ventre, Sara E Martin, Jessica Dawson, Roberta Cox, Heather M Moore, Sarah Brethouwer, Sharon Sables-Baus, Christopher D Baker
BACKGROUND: Preparing families of children requiring long-term mechanical ventilation (LTMV) to manage medical emergencies at home is challenging. Opportunities for family caregivers to rehearse crisis management in a controlled setting before discharge are limited. OBJECTIVE: We aimed to create a multimodal discharge preparedness curriculum, incorporating high-fidelity simulation training, to prepare family caregivers of children with complex medical conditions requiring long-term mechanical ventilation...
September 21, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28943063/outpatient-laparoscopic-appendectomy-can-be-successfully-performed-for-uncomplicated-appendicitis-a-southwestern-surgical-congress-multicenter-trial
#8
Richard Frazee, Clay Cothren Burlew, Justin Regner, Robert McIntyre, Erik Peltz, Chris Cribari, Julie Dunn, Larry Butler, Paul Reckard, Sharmila Dissanaike, Karen Karimi, Charles Behnfield, Nic Melo, Daniel Margulies
BACKGROUND: Many laparoscopic procedures are now performed on an outpatient basis. We hypothesize laparoscopic appendectomy can be safely performed as an outpatient procedure. METHODS: Seven institutions adopted a previously described outpatient laparoscopic appendectomy protocol for uncomplicated appendicitis. Patients were dismissed unless there was a clinical indication for admission. Patient demographics, success with outpatient management, time of dismissal, morbidity, and readmissions were analyzed...
September 19, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28942971/survival-and-recurrence-after-acute-pulmonary-embolism-treated-with-pulmonary-embolectomy-in-thrombolysis-in-new-york-state-1999-to-2013
#9
Timothy Lee, Shinobu Itagaki, Yuting P Chiang, Natalia N Egorova, David H Adams, Joanna Chikwe
BACKGROUND: Pulmonary embolism (PE) results in more than 250,000 hospitalizations annually in the United States, with high mortality. Outcome data are limited, and reperfusion strategies remain controversial. Here we evaluated the outcomes of thrombolysis and surgical embolectomy in patients with acute PE using a statewide database. METHODS: Among 174,322 patients hospitalized with PE in New York State between 1999 and 2013, we performed a retrospective comparison of 2111 adults with acute PE who underwent either thrombolysis (n = 1854; 88%) or surgical embolectomy (n = 257; 12%) as first-line therapy...
August 31, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28942076/assessment-of-commonly-used-frailty-markers-for-high-and-extreme-risk-patients-undergoing-transcatheter-aortic-valve-replacement
#10
Jessica Forcillo, Jose F Condado, Yi-An Ko, Michael Yuan, Jose N Binongo, Nnaemeka M Ndubisi, John J Kelly, Vasilis Babaliaros, Robert A Guyton, Chandan Devireddy, Bradley G Leshnower, James P Stewart, Louis P Perrault, Paul Khairy, Vinod H Thourani
BACKGROUND: The effect of frailty on outcomes after transcatheter aortic valve replacement (TAVR) remains incompletely understood. The objective of this study was to evaluate the performance of four commonly used frailty markers as predictors of early and late outcomes among patients undergoing TAVR. METHODS: A review was performed of 361 high- and extreme-risk patients undergoing TAVR from 2011 to 2015. Four frailty variables were assessed: serum albumin (g/dL), 5-m walk (seconds), grip strength (kg), and Katz index of independence in activities of daily living...
September 21, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28942019/failure-patterns-in-standalone-anterior-cervical-discectomy-and-fusion-implants
#11
Fernando Alonso, Tarush Rustagi, Cameron Schmidt, Daniel C Norvell, R Shane Tubbs, Rod J Oskouian, Jens R Chapman, Christian Fisahn
INTRODUCTION: Anterior cervical discectomy and fusion is commonly performed using an allograft or autograft implant and anterior screw-supported plate. There has been an increase in the use of standalone cage devices due to ease of use and studies suggesting a lower rate of acute post-operative dysphagia. We review our experience with standalone cage devices and identify risk factors, patterns of failure, and revision surgery approaches. MATERIALS AND METHODS: We performed a retrospective case-series of patients treated at a single tertiary care institution between March 2014 and March 2015...
September 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28941946/increased-shoulder-arthroscopy-time-is-associated-with-overnight-hospital-stay-and-surgical-site-infection
#12
Venkat Boddapati, Michael C Fu, William W Schairer, Anil S Ranawat, David M Dines, Samuel A Taylor, Joshua S Dines
PURPOSE: The purpose of this study was to characterize the rates of short-term postoperative complications, readmissions, and overnight hospital stays as a function of shoulder arthroscopy procedure time. A secondary aim of this current study was to identify baseline patient risk factors for adverse outcomes. METHODS: This study used the American College of Surgeons National Surgical Quality Improvement Program registry from 2012 to 2015. Shoulder arthroscopy cases were categorized based on operative time, either <45 minutes, between 45 and 90 minutes, or >90 minutes...
September 20, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28941749/efficacy-of-a-transition-clinic-on-hospital-readmissions
#13
Vidya Chakravarthy, Mary J Ryan, Amir Jaffer, Robyn Golden, Regina McClenton, Jisu Kim, Irwin Press, Tricia Johnson
BACKGROUND: A primary care staffed transition clinic is one potential strategy for reducing thirty-day readmissions for patients without an established primary care physician, but the effectiveness has not been studied. The objective was to test whether patients who completed a post-discharge transition clinic appointment were less likely to be readmitted within thirty days. METHODS: This retrospective cross-sectional study included adults with Medicare and Medicaid coverage who were discharged from general medicine units at Rush University Medical Center between October 2013 and October 2014...
September 20, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28941724/operative-versus-non-operative-management-in-the-care-of-patients-with-complicated-appendicitis
#14
Thomas S Helling, Douglas F Soltys, Samantha Seals
BACKGROUND: The approach to complicated appendicitis is unclear. We have sought to determine factors which may persuade surgeons to non-operative management and whether such treatment affects outcome. METHODS: All adult patients admitted over a five-year period 2009-2014 with a diagnosis of appendicitis were reviewed. Patients were grouped into uncomplicated and complicated presentations and stratified by age, gender, ethnicity, socio-economic status, and time to presentation...
September 18, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28941658/surgical-readmission-and-survival-in-women-with-ovarian-cancer-are-short-term-quality-metrics-incentivizing-decreased-long-term-survival
#15
Emma L Barber, Emma C Rossi, Paola A Gehrig
OBJECTIVES: To determine the association between treatment with neoadjuvant chemotherapy (NACT) or primary debulking surgery (PDS) and readmission after surgical hospitalization as well as overall survival among women with stage IIIC epithelial ovarian cancer (EOC). METHODS: We identified incident cases of stage IIIC EOC treated with both chemotherapy and surgery in the National Cancer Database (NCDB) from 2006 to 2012. 30-day readmissions were categorized as planned or unplanned...
September 20, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28941611/quality-of-acute-myocardial-infarction-care-in-canada-a-10-year-review-of-30-day-in-hospital-mortality-and-30-day-hospital-readmission
#16
Dat T Tran, Robert C Welsh, Arto Ohinmaa, Nguyen X Thanh, Akshay Bagai, Padma Kaul
BACKGROUND: The recently released Canadian cardiac care quality indicators include 30-day in-hospital mortality and readmission rates after percutaneous coronary intervention (PCI) and isolated coronary artery bypass grafting (CABG). We examined long-term trends and provincial variations in these outcomes among acute myocardial infarction (AMI) patients. METHODS: We included patients aged 18 years and older who were hospitalized with a primary diagnosis of AMI between 2004 and 2013 in all Canadian provinces except Quebec...
October 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28941557/impact-of-discharge-anticoagulation-education-by-emergency-department-pharmacists-at-a-tertiary-academic-medical-center
#17
Elizabeth G Zdyb, D Mark Courtney, Sanjeev Malik, Michael J Schmidt, Abbie E Lyden
BACKGROUND: Although pharmacists commonly provide patient education and help manage high-risk anticoagulant medications in inpatient and outpatient settings, the evidence for these interventions in the emergency department (ED) is less established, especially in the era of direct-acting oral anticoagulants. In 2013, a formal program was initiated whereby patients discharged with a new prescription for any anticoagulant receive education from an ED pharmacist when on-site. In addition, they received follow-up phone calls from an ED pharmacist within 72 hours of discharge...
September 20, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28940914/do-hospitals-respond-to-rivals-quality-and-efficiency-a-spatial-panel-econometric-analysis
#18
Francesco Longo, Luigi Siciliani, Hugh Gravelle, Rita Santos
We investigate whether hospitals in the English National Health Service change their quality or efficiency in response to changes in quality or efficiency of neighbouring hospitals. We first provide a theoretical model that predicts that a hospital will not respond to changes in the efficiency of its rivals but may change its quality or efficiency in response to changes in the quality of rivals, though the direction of the response is ambiguous. We use data on eight quality measures (including mortality, emergency readmissions, patient reported outcome, and patient satisfaction) and six efficiency measures (including bed occupancy, cancelled operations, and costs) for public hospitals between 2010/11 and 2013/14 to estimate both spatial cross-sectional and spatial fixed- and random-effects panel data models...
September 2017: Health Economics
https://www.readbyqxmd.com/read/28940537/spending-per-medicare-beneficiary-is-higher-in-hospital-owned-small-and-medium-sized-physician-practices
#19
Michael F Pesko, Andrew M Ryan, Stephen M Shortell, Kennon R Copeland, Patricia P Ramsay, Xuming Sun, Jayme L Mendelsohn, Diane R Rittenhouse, Lawrence P Casalino
OBJECTIVE: To examine the relationship of physician versus hospital ownership of small- and medium-sized practices with spending and utilization of care. DATA SOURCE/STUDY SETTING/DATA COLLECTION: Survey data for 1,045 primary care-based practices of 1-19 physicians linked to Medicare claims data for 2008 for 282,372 beneficiaries attributed to the 3,010 physicians in these practices. STUDY DESIGN: We used generalized linear models to estimate the associations between practice characteristics and outcomes (emergency department visits, index admissions, readmissions, and spending)...
September 21, 2017: Health Services Research
https://www.readbyqxmd.com/read/28940480/thirty-day-morbidity-and-mortality-following-otologic-neurotologic-surgery-analysis-of-the-national-surgical-quality-improvement-program
#20
Zachary G Schwam, Elias Michaelides, Phoebe Kuo, Michael A Hajek, Benjamin L Judson, Christopher Schutt
OBJECTIVES/HYPOTHESIS: To determine the rate and timing of, as well as risk factors for, postoperative morbidity and mortality following otologic and neurotologic surgery. STUDY DESIGN: Retrospective cohort study. METHODS: A total of 1,381 patients were identified in the American College of Surgeons National Surgical Quality Improvement Program for the years 2005 to 2010. Simple summary statistics, χ(2) , and multivariable logistic regression were performed...
September 22, 2017: Laryngoscope
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