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https://www.readbyqxmd.com/read/28732420/letter-to-the-editor-regarding-impact-of-intraoperative-monitoring-during-elective-complex-spinal-fusions-%C3%A2-4-levels-on-30-day-complication-and-readmission-rates-a-single-institutional-study-of-643-adult-spinal-deformity-patients
#1
https://www.readbyqxmd.com/read/28731914/phenotype-of-same-day-discharge-patients-after-percutaneous-coronary-intervention
#2
Donna V Ramharrack, Corrine Y Jurgens, Richard A Shlofmitz
BACKGROUND: Overnight observation is the standard of care for uncomplicated elective percutaneous coronary intervention (PCI). However, same-day discharge (SDD) is reportedly safe using predetermined criteria and patient risk categories. Characteristics of patients with SDD have not yet been described. OBJECTIVE: The purpose of this study was to describe the phenotype of patients appropriate for SDD after PCI without predetermined criteria and patient risk categories...
July 20, 2017: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28730986/long-term-use-of-left-ventricular-assist-devices-a-report-on-clinical-outcomes
#3
Sneha Raju, Jane MacIver, Farid Foroutan, Carolina Alba, Filio Billia, Vivek Rao
BACKGROUND: The literature examining clinical outcomes and readmissions during extended (> 1 yr) left ventricular assist device (LVAD) support is scarce, particularly in the era of continuous-flow LVADs. METHODS: We completed a retrospective cohort study on consecutive LVAD patients from June 2006 to March 2015, focusing on those who received more than 1 year of total LVAD support time. Demographic characteristics, clinical outcomes and readmissions were analyzed using standard statistical methods...
August 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28730744/improving-hospital-discharge-arrangements-for-people-who-are-homeless-a-realist-synthesis-of-the-intermediate-care-literature
#4
REVIEW
Michelle Cornes, Martin Whiteford, Jill Manthorpe, Joanne Neale, Richard Byng, Nigel Hewett, Michael Clark, Alan Kilmister, James Fuller, Robert Aldridge, Michela Tinelli
This review presents a realist synthesis of "what works and why" in intermediate care for people who are homeless. The overall aim was to update an earlier synthesis of intermediate care by capturing new evidence from a recent UK government funding initiative (the "Homeless Hospital Discharge Fund"). The initiative made resources available to the charitable sector to enable partnership working with the National Health Service (NHS) in order to improve hospital discharge arrangements for people who are homeless...
July 20, 2017: Health & Social Care in the Community
https://www.readbyqxmd.com/read/28730536/effectiveness-and-feasibility-of-robotic-gastric-neurostimulator-placement-in-patients-with-refractory-gastroparesis
#5
Mia Mowzoon, Francisco Igor B Macedo, Jaskiran Kaur, Ramachandra Kolachalam
Gastric neurostimulation (GNS) with Enterra(®) therapy device (Medtronic, Minneapolis, MN) appears as the last resort for patients with refractory gastroparesis. Currently, the device has Humanitarian Use status by Food and Drug Administration, thereby requiring further investigation. We aim to describe its feasibility and clinical outcomes using robotic technique. From June 2014 to September 2016, 15 consecutive patients underwent robotic insertion of Enterra(®) device. Patient demographics, comorbidities, and clinical outcomes including mortality, length of stay, readmission rates, reoperation and complications were retrospectively collected...
July 20, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28730275/comparative-analysis-of-open-and-robotic-transversus-abdominis-release-for-ventral-hernia-repair
#6
James G Bittner, Sameer Alrefai, Michelle Vy, Micah Mabe, Paul A R Del Prado, Natasha L Clingempeel
BACKGROUND: Transversus abdominis release (TAR) is a safe, effective strategy to repair complex ventral incisional hernia (VIH); however, open TAR (o-TAR) often necessitates prolonged hospitalization. Robot-assisted TAR (r-TAR) may benefit short-term outcomes and shorten convalescence. This study compares 90-day outcomes of o-TAR and r-TAR for VIH repair. METHODS: A single-center, retrospective review of patients who underwent o-TAR or r-TAR for VIH from 2015 to 2016 was conducted...
July 20, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28728827/the-use-of-perioperative-ketorolac-in-the-surgical-treatment-of-pediatric-spontaneous-pneumothorax
#7
R Michael Dorman, George Ventro, Sarah B Cairo, Kaveh Vali, David H Rothstein
BACKGROUND: We sought to determine the effect of ketorolac on pediatric primary spontaneous pneumothorax recurrence after operation. METHODS: The Pediatric Health Information System database was queried for patients ages 10-16years discharged in the years 2004-2014 with pneumothorax or pleural bleb and a related operative procedure. Deaths and secondary pneumothorax were excluded. Variables included demographics, chronic disease, intensive care unit admission, mechanical ventilation, and lung resection or plication...
June 23, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28728783/enhanced-recovery-pathway-versus-standard-care-in-patients-undergoing-video-assisted-thoracoscopic-lobectomy
#8
Alessandro Brunelli, Caroline Thomas, Padma Dinesh, Andrew Lumb
OBJECTIVE: The objective of this study was to compare outcomes after video-assisted thoracoscopic lobectomy or segmentectomy before and after introduction of an enhanced recovery program. METHODS: Data from 600 patients undergoing video-assisted lobectomy or segmentectomy between April 2014 and January 2017 were analyzed. A comparative analysis was performed between patients undergoing operation before (365 patients) and after (235 patients) the start of the enhanced recovery program...
June 22, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28728745/early-readmissions-after-acute-myocardial-infarction
#9
Chun Shing Kwok, Chun Wai Wong, Hannah Shufflebotham, Luke Brindley, Tamseel Fatima, Adrian Shufflebotham, Diane Barker, Ashish Pawala, Grant Heatlie, Mamas A Mamas
This study aims to evaluate the rate, predictors, and causes of 30-day readmissions in a single tertiary hospital in the United Kingdom. We conducted a retrospective study of all patients admitted between 2012 and 2014 with a diagnosis of acute myocardial infarction, who were in the Myocardial Infarction National Audit Project register. Data on patient demographics, comorbidities, care received, and in-hospital mortality were collected. Rates of 30-day readmission and causes of readmission were evaluated. Univariate and multiple logistic regressions were used to identify predictors of all-cause, cardiac, and noncardiac readmission...
June 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28728683/nutritional-intervention-in-acute-heart-failure-patients-with-undernutrition-and-normalbuminemia-a-subgroup-analysis-of-picnic-study
#10
Esmeralda Ramiro-Ortega, Juan L Bonilla-Palomas, Antonio L Gámez-López, Mirian Moreno-Conde, María C López-Ibáñez, Rosa Alhambra-Expósito, Manuel Anguita Sánchez
BACKGROUND & AIMS: Hypoalbuminemia is common in acute heart failure (HF) patients and has been associated with increased hospital mortality and long-term mortality. Undernutrition is a factor causing hypoalbuminemia. The PICNIC study results show that a nutritional intervention in undernourished acute HF patients reduces the risks of all-cause death and of readmission for HF. We aimed to investigate whether the efficacy of a nutritional intervention is consistent among the subgroups of patients with and without hypoalbuminemia...
July 14, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28727619/an-innovative-transitional-care-program-improves-community-health
#11
Barbara M Richardson
In this month's Magnet® Perspectives column, Barbara Richardson, MSN, RN-BC, CCRN, clinical nurse specialist at the Southwestern Vermont Medical Center, examines the ways in which a robust transitional care program improves community health, reduces readmissions and emergency department visits, and provides valuable social support for even the most complex patients. Richardson shares critical factors that impacted the program's success, including a Magnet® environment of innovation, a visionary hospital leadership team, strong community alliances, and collaborative solutions to previously intractable problems...
July 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/28726539/rethinking-transitions-of-care-an-interprofessional-transfer-triage-protocol-in-post-acute-care
#12
Radha V Patel, Lauri Wright, Brittany Hay
Readmissions to hospitals from post-acute care (PAC) units within long-term care settings have been rapidly increasing over the past decade, and are drivers of increased healthcare costs. With an average of $11,000 per admission, there is a need for strategies to reduce 30-day preventable hospital readmission rates. In 2018, incentives and penalties will be instituted for long-term care facilities failing to meet all-cause, all-condition hospital readmission rate performance measures. An interprofessional team (IPT) developed and implemented a Transfer Triage Protocol used in conjunction with the INTERACT programme to enhance clinical decision-making and assess the potential to reduce the facility's 30-day preventable hospital readmission rates by 10% within 6 weeks of implementation...
July 20, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28726135/increasing-bile-duct-injury-and-decreasing-utilization-of-intraoperative-cholangiogram-and-common-bile-duct-exploration-over-14%C3%A2-years-an-analysis-of-outcomes-in-new-york-state
#13
Maria S Altieri, Jie Yang, Nabeel Obeid, Chencan Zhu, Mark Talamini, Aurora Pryor
INTRODUCTION: During laparoscopic cholecystectomy (LC), common bile duct (CBD) visualization either directly or with cholangiography (IOC) is less routine. Cholangiography can be used to identify and possibly prevent bile duct injury (BDI), which is a dreaded complication of cholecystectomy. The purpose of our study was to evaluate the trend of IOC/CBD exploration and BDI during LC for benign disease. METHODS: A state-wide database (SPARCS) was used to identify all LC for benign biliary non-obstructive and obstructive disease between 2000 and 2014 in the state of New York...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28724682/from-the-memphis-model-to-the-north-carolina-way-lessons-learned-from-emerging-health-system-and-faith-community-partnerships
#14
Teresa Cutts, Gary Gunderson, Dean Carter, Melanie Childers, Phillip Long, Lisa Marisiddaiah, Helen Milleson, Dennis Stamper, Annika Archie, Jeremy Moseley, Emily Viverette, Bobby Baker
National health care policy has encouraged health systems to develop community partnerships designed to decrease costs and readmissions, particularly for underserved populations. This commentary describes and compares the Congregational Health Network's Memphis Model to early local efforts at clinical-faith community partnerships in North Carolina, which we call "The North Carolina Way." Necessary components for building robust health system and congregational partnerships to address social determinants of health and impact health care utilization include partnership growth, allocation of health system resources, community trust, and time...
July 2017: North Carolina Medical Journal
https://www.readbyqxmd.com/read/28724505/readmission-to-hospital-of-medical-patients-a-cohort-study
#15
Mette Gothardt Rasmussen, Pernille Ravn, Stig Molsted, Lise Tarnow, Susanne Rosthøj
INTRODUCTION: The incidence of acute readmissions is higher among elderly medical patients than in the general population. Risk factor identification is needed in order to prevent readmissions. OBJECTIVE: To estimate the incidence of acute readmissions among medical patients ≥65years discharged from departments of internal medicine and to identify risk factors associated with readmissions. MATERIAL AND METHODS: We included patients discharged between 1st of January 2011 and 1st of December 2014 and collected data regarding primary diagnosis and comorbidities...
July 16, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28724126/comparative-outcomes-after-percutaneous-coronary-intervention-among-black-and-white-patients-treated-at-us-veterans-affairs-hospitals
#16
Taisei Kobayashi, Thomas J Glorioso, Ehrin J Armstrong, Thomas M Maddox, Mary E Plomondon, Gary K Grunwald, Steven M Bradley, Thomas T Tsai, Stephen W Waldo, Sunil V Rao, Subhash Banerjee, Brahmajee K Nallamothu, Deepak L Bhatt, A Garvey Rene, Robert L Wilensky, Peter W Groeneveld, Jay Giri
Importance: Current comparative outcomes among black and white patients treated with percutaneous coronary intervention (PCI) in the Veterans Affairs (VA) health system are not known. Objective: To compare outcomes between black and white patients undergoing PCI in the VA health system. Design, Setting, and Participants: This study compared black and white patients who underwent PCI between October 1, 2007, and September 30, 2013, at 63 VA hospitals using data recorded in the VA Clinical Assessment, Reporting, and Tracking System for Cardiac Catheterization Laboratories (CART-CL) program...
July 19, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28723921/postnatal-dexamethasone-respiratory-and-neurodevelopmental-outcomes-at-two-years-in-babies-born-extremely-preterm
#17
Gordon Qin, Jessica W Lo, Neil Marlow, Sandy A Calvert, Anne Greenough, Janet L Peacock
IMPORTANCE: Postnatal dexamethasone is associated with reduction in bronchopulmonary dysplasia. There remains, however, concern that its short-term benefits are accompanied by long-term adverse effects e.g. poorer neurodevelopmental outcomes. OBJECTIVE: Our aim was to determine the effects of administration of postnatal dexamethasone on respiratory and neurodevelopmental outcome at two years of age after adjusting for neonatal and infant risk factors. MATERIALS AND METHODS: The study included 412 infants born at 23-28 weeks of gestation, 29% had received postnatal dexamethasone...
2017: PloS One
https://www.readbyqxmd.com/read/28723873/total-disc-arthroplasty-and-anterior-interbody-fusion-in-the-lumbar-spine-have-relatively-few-differences-in-readmission-and-short-term-adverse-events
#18
Blake N Shultz, Alexander T Wilson, Nathaniel T Ondeck, Patawut Bovonratwet, Ryan P McLynn, Jonathan J Cui, Jonathan N Grauer
STUDY DESIGN: Retrospective matched cohort study of prospectively collected data. OBJECTIVE: To compare rates of adverse events and readmission between lumbar total disc arthroplasty (TDA) and anterior lumbar interbody fusion (ALIF) using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. SUMMARY OF BACKGROUND DATA: TDA and ALIF may be considered for similar degenerative indications. However, there have been few large-cohort comparison studies of short-term clinical outcomes for these procedures...
July 18, 2017: Spine
https://www.readbyqxmd.com/read/28721034/readmission-after-copd-exacerbation-scale-determining-30-day-readmission-risk-for-copd-patients
#19
Christine Sm Lau, Brianna L Siracuse, Ronald S Chamberlain
BACKGROUND: COPD affects over 13 million Americans, and accounts for over half a million hospitalizations annually. The Hospital Readmission Reduction Program, established by the Affordable Care Act requires the Centers for Medicare and Medicaid Services to reduce payments to hospitals with excess readmissions for COPD as of 2015. This study sought to develop a predictive readmission scale to identify COPD patients at higher readmission risk. METHODS: Demographic and clinical data on 339,389 patients from New York and California (derivation cohort) and 258,113 patients from Washington and Florida (validation cohort) were abstracted from the State Inpatient Database (2006-2011), and the Readmission After COPD Exacerbation (RACE) Scale was developed to predict 30-day readmission risk...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28720164/the-detection-diagnosis-and-impact-of-cognitive-impairment-among-inpatients-aged-65-years-and-over-in-an-irish-general-hospital-a-prospective-observational-study
#20
Clodagh Power, Richard Duffy, Helena Bates, Mike Healy, Petrina Gleeson, Brian A Lawlor, Elaine Greene
BACKGROUND: The diagnosis of dementia remains inadequate, even within clinical settings. Data on rates and degree of impairment among inpatients are vital for service planning and the provision of appropriate patient care as Ireland's population ages. METHODS: Every patient aged 65 years and over admitted over a two-week period was invited to participate. Those who met inclusion criteria were screened for delirium then underwent cognitive screening. Demographic, functional, and outcome data were obtained from medical records, participants, and family...
July 19, 2017: International Psychogeriatrics
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