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https://www.readbyqxmd.com/read/28549099/impact-of-resident-and-fellow-changeovers-on-patient-outcomes-a-nationwide-cross-sectional-study
#1
Jean-David Zeitoun, Jeanne Reboul-Marty, Jérémie H Lefèvre
Findings regarding the association of cohort changeovers with patient outcomes are mixed. We sought to examine the association of resident and fellow changeovers with a comprehensive set of indicators. We performed a cross-sectional comparative study including all French teaching and non-teaching hospitals. All-cause mortality and length of stay were assessed. Focused analysis for three medical conditions (myocardial infarction, intestinal hemorrhage, stroke) and three surgical procedures (colorectal, vascular and spine surgery) was performed regarding other quality and efficiency indicators (readmissions, intensive care unit admission, transfers)...
May 25, 2017: European Journal of Public Health
https://www.readbyqxmd.com/read/28549049/institution-of-a-preoperative-stoma-education-group-class-decreases-rate-of-peristomal-complications-in-new-stoma-patients
#2
Audrey L Stokes, Shelly Tice, Suzi Follett, Diane Paskey, Lini Abraham, Cheryl Bealer, Holly Keister, Walter Koltun, Frances J Puleo
PURPOSE: The purpose of this study was to compare selected postoperative complications (including stomal and peristomal complications), hospital length of stay, and readmission rates in a group of patients who attended a preoperative educational intervention to a retrospective group of patients who did not receive the intervention. DESIGN: Retrospective, comparison cohort study. SUBJECTS AND SETTING: The intervention group comprised 124 patients who attended an educational session for persons with fecal ostomies at a single tertiary care center in the Northeastern United States...
May 25, 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28549028/hybrid-coronary-revascularization-has-improved-short-term-outcomes-but-worse-mid-term-reintervention-rates-compared-to-cabg-a-propensity-matched-analysis
#3
Yu Xia, Abraham N Katz, Stephen J Forest, Robert T Pyo, Mark A Greenberg, Joseph J DeRose
OBJECTIVE: We evaluated short-term outcomes and mid-term survival and reintervention of hybrid coronary revascularization versus conventional coronary artery bypass grafting using a propensity score matched cohort. METHODS: We conducted a retrospective review of patients undergoing surgery for multivessel coronary artery disease from 2007 to 2015 at a single institution. Patients were propensity matched 1:1 to receiving hybrid coronary revascularization or conventional bypass grafting by multivariate logistic regression on preoperative characteristics...
May 25, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28549000/a-comparison-of-anterior-and-posterior-lumbar-interbody-fusions-complications-readmissions-discharge-dispositions-and-costs
#4
Rabia Qureshi, Varun Puvanesarajah, Amit Jain, Adam L Shimer, Francis H Shen, Hamid Hassanzadeh
STUDY DESIGN: Retrospective Database Review OBJECTIVE.: To understand medical complication rates, readmission rates, costs and discharge dispositions in ALIFs versus TLIF/PLIFs for lumbar degenerative disease. SUMMARY OF BACKGROUND DATA: Indications for anterior (ALIFs) vs posterior lumbar interbody fusions (PLIFs) can vary, though benefits of anterior approach surgery include full access to the anterior column and ability to place fusion devices. METHODS: The PearlDiver Database of Medicare records was utilized for this retrospective database review...
May 25, 2017: Spine
https://www.readbyqxmd.com/read/28548631/effectiveness-of-a-respiratory-day-hospital-program-to-reduce-admissions-for-exacerbation-in-patients-with-severe-copd-a-prospective-multicenter-study
#5
Daniel Huertas, Concepción Montón, Alicia Marín, Ingrid Solanes, Marta López-Sánchez, Xavier Pomares, Mariana Muñoz-Esquerre, Jordi Dorca, Salud Santos
The respiratory Day Hospital (DH) is a care facility currently operating at various healthcare institutions. It monitors patients with severe chronic obstructive pulmonary disease (COPD) presenting repeated exacerbations with at least two hospital admissions per year. The main aim of the study was to evaluate the effectiveness of the DH program for controlling admissions for COPD exacerbations in this cohort of patients, and to identify clinical factors associated with hospitalizations and mortality. An observational prospective multicenter study was carried out at three hospitals...
June 2017: COPD
https://www.readbyqxmd.com/read/28546776/economic-burden-of-hospitalizations-of-medicare-beneficiaries-with-heart-failure
#6
Meredith Kilgore, Harshali K Patel, Adrian Kielhorn, Juan F Maya, Pradeep Sharma
OBJECTIVE: The objective of this study was to assess the costs associated with the hospitalization and the cumulative 30-, 60-, and 90-day readmission rates in a cohort of Medicare beneficiaries with heart failure (HF). METHODS: This was a retrospective, observational study based on data from the national 5% sample of Medicare beneficiaries. Inpatient data were gathered for Medicare beneficiaries with at least one HF-related hospitalization between July 1, 2005, and December 31, 2011...
2017: Risk Management and Healthcare Policy
https://www.readbyqxmd.com/read/28546100/does-the-timing-of-loop-ileostomy-closure-affect-outcome-a-case-matched-study
#7
Wanglin Li, Gokhan Ozuner
INTRODUCTION: The optimal timing for the closure of loop ileostomies remains controversial. The aim of this study is to determine whether ileostomy closure (<3 months post formation) affects stoma-related morbidity compared to late closure (≥3 months post formation). METHODS: All patients who had loop ileostomy and ileostomy closure between 2012 and 2015 were identified from an IRB-approved, prospectively maintained institutional database.The patients who underwent ileostomy closure (<3 months) were compared against matched patients undergoing ileostomy closure (≥3 months)...
May 22, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28545885/evaluation-of-the-yale-new-haven-readmission-risk-score-for-pneumonia-in-a-general-hospital-population
#8
Gabrielle Schaefer, Robert El-Kareh, Jennifer Quartarolo, Gregory Seymann
BACKGROUND: The Yale New Haven Readmission Risk Score (YNHRRS) for pneumonia is a clinical prediction tool developed to assess risk for 30-day readmission. This tool was validated in a cohort of Medicare patients; generalizability to a broader patient population has not been evaluated. In addition, it lacks indicators of functional status or social support, which have been shown to be predictors of readmission in other studies. OBJECTIVE: To evaluate the generalizability of the YNHRRS for pneumonia in a general population of hospitalized patients, and assess the impact of incorporating measures of functional status and social support on its predictive value...
May 22, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28545851/sex-specific-risk-of-emergency-department-revisits-and-early-readmission-following-myocardial-infarction
#9
Magnus Lundbäck, Danijela Gasevic, Eric Rullman, Toralph Ruge, Axel C Carlsson, Martin J Holzmann
BACKGROUND: Readmissions within 30days after hospitalization have been introduced as a measure of quality of care. There is a paucity of data regarding sex-specific risk of early readmissions after myocardial infarction (MI). OBJECTIVES: To investigate the association between sex and revisits to the emergency department (ED), and readmissions after MI. METHODS: All patients with chest pain, diagnosed with MI at the Karolinska University Hospital during 2011 and 2012 were included...
May 19, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28545764/implementation-of-an-enhanced-recovery-protocol-in-pediatric-colorectal-surgery
#10
Heather L Short, Kurt F Heiss, Katelyn Burch, Curtis Travers, John Edney, Claudia Venable, Mehul V Raval
PURPOSE: Enhanced recovery protocols (ERPs) have been shown to improve outcomes in adult surgical populations. Our purpose was to compare outcomes before and after implementation of an ERP in children undergoing elective colorectal surgery. METHODS: A pediatric-specific colorectal ERP was developed and implemented at a single center starting in January 2015. A retrospective review was performed including 43 patients in the pre-ERP period (2012-2014) and 36 patients in the post-ERP period (2015-2016)...
May 12, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28545741/-performance-and-optimisation-of-a-trigger-tool-for-the-detection-of-adverse-events-in-hospitalised-adult-patients
#11
Óscar Guzmán Ruiz, Juan José Pérez Lázaro, Pedro Ruiz López
OBJECTIVE: To characterise the performance of the triggers used in the detection of adverse events (AE) of hospitalised adult patients and to define a simplified panel of triggers to facilitate the detection of AE. METHOD: Cross-sectional study of charts of patients from a service of internal medicine to detect EA through systematic review of the charts and identification of triggers (clinical event often related to AE), determining if there was AE as the context in which it appeared the trigger...
May 22, 2017: Gaceta Sanitaria
https://www.readbyqxmd.com/read/28545640/artificial-intelligence-in-precision%C3%A2-cardiovascular-medicine
#12
REVIEW
Chayakrit Krittanawong, HongJu Zhang, Zhen Wang, Mehmet Aydar, Takeshi Kitai
Artificial intelligence (AI) is a field of computer science that aims to mimic human thought processes, learning capacity, and knowledge storage. AI techniques have been applied in cardiovascular medicine to explore novel genotypes and phenotypes in existing diseases, improve the quality of patient care, enable cost-effectiveness, and reduce readmission and mortality rates. Over the past decade, several machine-learning techniques have been used for cardiovascular disease diagnosis and prediction. Each problem requires some degree of understanding of the problem, in terms of cardiovascular medicine and statistics, to apply the optimal machine-learning algorithm...
May 30, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28545542/recognition-and-treatment-of-sleep-disordered-breathing-an-important-component-of-chronic-disease-management
#13
REVIEW
Peter C Farrell, Glenn Richards
Sleep-disordered breathing (SDB) is a highly prevalent condition, and is associated with many debilitating chronic diseases. The role of untreated obstructive sleep apnea (OSA) in arterial hypertension has been recognized in international guidelines. Treatment with continuous positive airway pressure (CPAP) is associated with clinically-relevant reductions in blood pressure. In heart failure (HF), SDB is associated with worse prognosis and increased mortality. Major HF guidelines recommend that patients should be treated for sleep apnea to improve their HF status...
May 25, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28544520/safety-and-perioperative-adverse-events-in-pediatric-endoscopic-sinus-surgery-an-acs-nsqip-p-analysis
#14
Christopher R Roxbury, Lilun Li, Daniel Rhee, Kris R Jatana, Rahul K Shah, Emily F Boss
INTRODUCTION: This study describes safety outcomes of pediatric endoscopic sinus surgery (ESS) to identify risk factors for 30-day postoperative adverse events using the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database. METHODS: We performed a retrospective cohort study involving patients in the 2012-2015 NSQIP-P database who underwent ESS. Predictors included demographics, comorbidities and surgical acuity. Outcomes included 30-day complications, reoperations, and readmissions...
May 23, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28544311/impact-of-body-mass-index-on-robotic-radical-cystectomy-with-intra-corporeal-urinary-diversion
#15
Nariman Ahmadi, Thomas G Clifford, Gus Miranda, Jie Cai, Monish Aron, Mihir M Desai, Inderbir S Gill
OBJECTIVES: To determine the impact of body mass index (BMI) on peri-operative and oncological outcomes following robotic radical cystectomy (RRC) with intra-corporeal urinary diversion (ICUD). SUBJECTS AND METHODS: A total of 216 patients undergoing RRC, extended lymphadenectomy and ICUD (07/2010-12/2015) were categorized into four BMI groups according to the 2004 World Health Organization (WHO) obesity classification: <25 kg/m(2) (normal), 25-29.9 kg/m(2) (pre-obese), 30-34...
May 22, 2017: BJU International
https://www.readbyqxmd.com/read/28543359/impact-of-resident-involvement-in-outpatient-otolaryngology-procedures-an-analysis-of-17-647-cases
#16
Andrew B Baker, Adrian A Ong, Brendan P O'Connell, Alexander D Sokohl, William B Clinkscales, Ted A Meyer
OBJECTIVE: This study examines the impact of resident physician participation on postoperative outcomes in outpatient otolaryngologic surgery. STUDY DESIGN: Retrospective cohort. METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was queried for outpatient otolaryngologic procedures performed on adult patients. Cases were analyzed with the following cohorts: attending with resident or attending without resident...
May 23, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28543108/complications-and-30-day-hospital-readmission-rates-of-patients-undergoing-tracheostomy-a-prospective-analysis
#17
Emily Spataro, Nedim Durakovic, Dorina Kallogjeri, Brian Nussenbaum
OBJECTIVE: To determine inpatient and outpatient tracheostomy complication rates and 30-day hospital readmission rates, and to assess patient and procedural risk factors associated with complications and readmissions. STUDY DESIGN: Prospective cohort study. METHODS: Adult patients undergoing tracheostomy at a single academic hospital performed by any service, for any indication, were enrolled in this study over the course of 1 year. All patients had complete 30-day follow-up after discharge to determine complication and hospital readmission rates...
May 23, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28541569/implementation-and-evaluation-of-a-smartphone-application-for-the-perioperative-care-of-neurosurgery-patients-at-an-academic-medical-center-implications-for-patient-satisfaction-surgery-cancelations-and-readmissions
#18
Daniel R Felbaum, Jeffrey J Stewart, Amjad N Anaizi, Faheem A Sandhu, Mani N Nair, Jean-Marc Voyadzis
BACKGROUND: Smartphone applications (apps) in the health care arena are being increasingly developed with the aim of benefiting both patients and their physicians. The delivery of adequate instructions both before and after a procedure or surgery is of paramount importance in ensuring the best possible outcome for patients. OBJECTIVE: To demonstrate that app-based instructions with built-in reminders may improve patient understanding and compliance and contribute to reducing the number of surgery cancellations and postoperative complications and readmissions...
May 25, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28540047/clinical-outcomes-for-the-obese-hospital-inpatient-an-observational-study
#19
K L Fusco, H C Robertson, H Galindo, P H Hakendorf, C H Thompson
OBJECTIVES: The prevalence of obesity presents a burden for Australian health care. The aim of this study was to determine whether severely obese hospital inpatients have worse outcomes. METHODS: This is an observational cohort study, using data from all adult patients admitted to hospital for all elective and emergency admissions of patients aged over 18 years to two large Australian urban hospitals. We measured their length of stay, intensive care unit admission rate, intensive care unit length of stay, mortality and readmission rates within 28 days of discharge and compared these outcomes in the severely obese and non-severely obese subjects using t-test or chi-square test as appropriate...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28539569/stent-versus-non-stent-in-treating-intermediate-stenosis-culprit-lesions-in-acute-st-segment-elevation-myocardial-infarction-patients
#20
Jing Dai, Shuzheng Lyu, Xiantao Song, Min Zhang, Shaoping Nie, Hai Gao, Yujie Zeng, Wei Wang, Mingduo Zhang, Dongfeng Zhang, Jinfan Tian
To investigate the efficacy and safety of stent versus non-stent in treating acute ST-segment elevation myocardial infarction (STEMI) patients with single vessel disease and intermediate stenosis culprit lesions.Between September 2009 and May 2015, 475 acute STEMI patients (time from symptom onset < 12 hours) with single vessel disease and intermediate stenosis culprit lesions were retrospectively studied at Beijing Anzhen Hospital. The patients were divided into a stent group (n = 308) and non-stent group (n = 167) based on whether they received stent implantation or not during primary coronary angiography...
May 23, 2017: International Heart Journal
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