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https://www.readbyqxmd.com/read/29145548/supported-discharge-teams-for-older-people-in-hospital-acute-care-hospital-a-randomised-controlled-trial
#1
Matthew Parsons, John Parsons, Paul Rouse, Avinesh Pillai, Sean Mathieson, Rochelle Parsons, Christine Smith, Tim Kenealy
Background: Supported Discharge Teams aim to help with the transition from hospital to home, whilst reducing hospital length-of-stay. Despite their obvious attraction, the evidence remains mixed, ranging from strong support for disease-specific interventions to less favourable results for generic services. Objective: To determine whether older people referred to a Supported Discharge Team have: (i) reduced length-of-stay in hospital; (ii) reduced risk of hospital readmission; and (iii) reduced healthcare costs...
November 14, 2017: Age and Ageing
https://www.readbyqxmd.com/read/29145414/five-year-survival-and-associated-factors-in-women-treated-for-cervical-cancer-at-a-reference-hospital-in-the-brazilian-amazon
#2
Saul Rassy Carneiro, Marcela de Araújo Fagundes, Pricila de Jesus Oliveira do Rosário, Laura Maria Tomazi Neves, Givago da Silva Souza, Maria da Conceição Nascimento Pinheiro
Cervical cancer (CC) is the most common type of cancer in women and is the third leading cause of death in most developing countries, causing more than 288,000 deaths in women worldwide each year. The most favourable survival rate is in developed countries, since CC mortality has recently declined in those countries. The purpose of this study was to determine the survival rate and associated factors of CC patients at a reference hospital in the Amazon region. The patient sample included records of 339 patients with cervical cancer who had been hospitalized in Belém, Pará, Brazil from January 2005 to December 2010; the socioeconomic and clinical data were collected between June and September 2016...
2017: PloS One
https://www.readbyqxmd.com/read/29143480/telephone-discharge-support-for-frail-vulnerable-older-people-discharged-from-hospital-impact-on-readmission-rates-participant-and-general-practitioner-feedback
#3
Claire P Heppenstall, Hugh C Hanger, Timothy J Wilkinson, Michelle Dhanak
OBJECTIVE: To assess the use and acceptability to older participants and general practitioners (GPs) of telephone support postdischarge to reduce readmissions. METHODS: A prospective cohort study of older people after discharge from a specialist geriatric unit, and comparison with a previous cohort. Telephone follow-up calls were made fortnightly for three months. Structured questionnaires were used to obtain feedback from participants and GPs. RESULTS: Readmission rates were high, 40%, despite the intervention...
November 15, 2017: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/29141781/heart-failure-with-preserved-borderline-and-reduced-ejection-fraction-5-year-outcomes
#4
Kevin S Shah, Haolin Xu, Roland A Matsouaka, Deepak L Bhatt, Paul A Heidenreich, Adrian F Hernandez, Adam D Devore, Clyde W Yancy, Gregg C Fonarow
BACKGROUND: Patients with heart failure (HF) have a poor prognosis and are categorized by ejection fraction (EF). OBJECTIVES: This study sought to characterize differences in outcomes in patients hospitalized with heart failure with preserved ejection fraction (HFpEF) (EF ≥50%), heart failure with borderline ejection fraction (HFbEF) (EF 41% to 49%), and heart failure with reduced ejection fraction (HFrEF) (EF ≤40%). METHODS: Data from GWTG-HF (Get With The Guidelines-Heart Failure) were linked to Medicare data for longitudinal follow-up...
October 31, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29139194/advantages-of-care-for-patients-with-hip-fractures-in-the-acute-geriatric-unit-hip-study-anoia
#5
Enric Duaso, Francesc Formiga, Patrícia Marimón, Montserrat Sandiumenge, Maria Teresa Salgado, Victor Murga, Andrés Gamboa, Carlos Rodriguez, Jaume Castellà, Enrique Escalante, Célia Lumbreras, Anna Tarrida, Ramón Sellarès
AIM: Hip fracture as a result of bone fragility is characterized by poor health outcomes in the medium and long term. Our goal was to compare a new orthogeriatric model with the old trauma model and evaluate improvements in clinical management. METHODS: We carried out a comparative unicentric study, a historical sample (trauma model) collected from 1 June 2007 to 31 May 2010, versus a prospective sample (orthogeriatric model) collected from 1 June 2010 until 31 May 2013...
November 15, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29137576/perioperative-assessment-of-older-surgical-patients-using-a-frailty-index-feasibility-and-association-with-adverse-post-operative-outcomes
#6
H Lin, N M Peel, I A Scott, D L Vardesh, P Sivalingam, R L McBride, J J Morong, M J Nelson, R E Hubbard
This study aimed to examine the feasibility of using a frailty index (FI) based on comprehensive geriatric assessment (CGA), to assess the level of frailty in older surgical patients preoperatively and to evaluate the association of FI-CGA with poorer postoperative outcomes. Two hundred and forty-six patients aged ≥70 years undergoing intermediate- to high-risk surgery in a tertiary hospital were recruited. Frailty was assessed using a 57-item FI-CGA form, with fit, intermediate frail, and frail patients defined as FI ≤0...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29137556/all-cause-30-day-readmissions-among-persons-with-intellectual-and-developmental-disabilities-and-mental-illness
#7
Robert Balogh, Elizabeth Lin, Kristin Dobranowski, Avra Selick, Andrew S Wilton, Yona Lunsky
OBJECTIVE: Early hospital readmissions within 30 days of discharge are common and costly. This research describes predictors of all-cause, 30-day hospital readmissions among persons with intellectual and developmental disabilities (IDD), a group known to experience high rates of hospitalization. METHODS: A cohort of 66,484 adults with IDD from Ontario, Canada, was used to create two subgroups: individuals with IDD only and those with IDD and mental illness. The rates of hospital readmission were determined and contrasted with a comparison subgroup of people without IDD who have mental illness...
November 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29135772/can-composite-measures-provide-a-different-perspective-on-provider-performance-than-individual-measures
#8
Michael Shwartz, Amy K Rosen, James F Burgess
BACKGROUND: Composite measures, which aggregate performance on individual measures into a summary score, are increasingly being used to evaluate facility performance. There is little understanding of the unique perspective that composite measures provide. OBJECTIVE: To examine whether high/low (ie, high or low) performers on a composite measures are also high/low performers on most of the individual measures that comprise the composite. METHODS: We used data from 2 previous studies, one involving 5 measures from 632 hospitals and one involving 28 measures from 112 Veterans Health Administration (VA) nursing homes; and new data on hospital readmissions for 3 conditions from 131 VA hospitals...
December 2017: Medical Care
https://www.readbyqxmd.com/read/29135663/serum-fructosamine-a-simple-and-inexpensive-test-for-assessing-preoperative-glycemic-control
#9
Noam Shohat, Majd Tarabichi, Eric H Tischler, Serge Jabbour, Javad Parvizi
BACKGROUND: Although the medical community acknowledges the importance of preoperative glycemic control, the literature is inconclusive and the proper metric for assessment of glycemic control remains unclear. Serum fructosamine reflects the mean glycemic control in a shorter time period compared with glycated hemoglobin (HbA1c). Our aim was to examine its role in predicting adverse outcomes following total joint arthroplasty. METHODS: Between 2012 and 2013, we screened all patients undergoing total joint arthroplasty preoperatively using serum HbA1c, fructosamine, and blood glucose levels...
November 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29135661/reconsidering-the-affordable-care-act-s-restrictions-on-physician-owned-hospitals-analysis-of-cms-data-on-total-hip-and-knee-arthroplasty
#10
P Maxwell Courtney, Brian Darrith, Daniel D Bohl, Nicholas B Frisch, Craig J Della Valle
BACKGROUND: Concerns about financial incentives and increased costs prompted legislation limiting the expansion of physician-owned hospitals in 2010. Supporters of physician-owned hospitals argue that they improve the value of care by improving quality and reducing costs. The purpose of the present study was to determine whether physician-owned and non-physician-owned hospitals differ in terms of costs, outcomes, and patient satisfaction in the setting of total hip arthroplasty (THA) and total knee arthroplasty (TKA)...
November 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29134688/neutropenic-fever-during-peripheral-blood-progenitor-cell-mobilization-is-associated-with-decreased-cd34-cell-collection-and-increased-apheresis-collection-days
#11
Jack Khouri, Lisa Rybicki, Navneet Majhail, Matt Kalaycio, Edward Copelan, Brad Pohlman, Brian Hill, Robert Dean, Aleksandr Lazaryan, Betty Hamilton, Steven Andresen, Ronald Sobecks, Brian Bolwell, Hien Liu
BACKGROUND: Peripheral blood progenitor cell (PBPC) mobilization with chemotherapy in addition to Granulocyte-Colony Stimulating Factor (G-CSF) improves cell collection compared to G-CSF alone; however, it is associated with increased risk of neutropenic fever (NF). METHODS: We analyzed risk factors for post-priming NF and NF association with autologous stem cell transplant outcomes. Between 1998 and 2008, 593 adult patients with lymphoma underwent PBPC mobilization with etoposide and G-CSF...
November 14, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/29133331/malnutrition-and-its-association-with-readmission-and-death-within-7-days-and-8-180-days-postdischarge-in-older-patients-a-prospective-observational-study
#12
Yogesh Sharma, Michelle Miller, Billingsley Kaambwa, Rashmi Shahi, Paul Hakendorf, Chris Horwood, Campbell Thompson
OBJECTIVE: The relationship between admission nutritional status and clinical outcomes following hospital discharge is not well established. This study investigated whether older patients' nutritional status at admission predicts unplanned readmission or death in the very early or late periods following hospital discharge. DESIGN, SETTING AND PARTICIPANTS: The study prospectively recruited 297 patients ≥60 years old who were presenting to the General Medicine Department of a tertiary care hospital in Australia...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29133324/effects-of-falls-prevention-interventions-on-falls-outcomes-for-hospitalised-adults-protocol-for-a-systematic-review-with-meta-analysis
#13
Susan C Slade, David L Carey, Anne-Marie Hill, Meg E Morris
INTRODUCTION: Falls are a major global public health problem and leading cause of accidental or unintentional injury and hospitalisation. Falls in hospital are associated with longer length of stay, readmissions and poor outcomes. Falls prevention is informed by knowledge of reversible falls risk factors and accurate risk identification. The extent to which hospital falls are prevented by evidence-based practice, patient self-management initiatives, environmental modifications and optimisation of falls prevention systems awaits confirmation...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29133263/prospective-evaluation-of-pasireotide-in-patients-undergoing-pancreaticoduodenectomy-the-washington-university-experience
#14
Ismael Dominguez-Rosado, Ryan C Fields, Cheryl A Woolsey, Gregory Williams, Timothy A Horwedel, J Bart Rose, Chet W Hammill, Maria B Doyle, William C Chapman, Steven M Strasberg, William G Hawkins, Dominic E Sanford
BACKGROUND: Pasireotide is a newer generation somatostatin analogue which led to a significant reduction in pancreatic fistula after pancreatectomy in a single-center randomized controlled trial. We sought to determine if pasireotide reduces the incidence of pancreatic fistula and other complications following pancreaticoduodenectomy at our high volume center. STUDY DESIGN: All patients between April 2011 and January 2017 undergoing pancreaticoduodenectomy were prospectively followed and their complications graded using the Modified Accordion Grading System (MAGS) in our institutional complications database...
November 10, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29132688/temporal-trends-in-outpatient-management-of-incident-pulmonary-embolism-and-associated-mortality
#15
Adi J Klil-Drori, Janie Coulombe, Samy Suissa, Andrew Hirsch, Vicky Tagalakis
INTRODUCTION: In clinical trial settings, outpatient management of pulmonary embolism (PE) is feasible and safe, but less is known on its use in routine care. We determined trends in outpatient management of PE and associated mortality in a large non-select patient population. METHODS: All residents of Quebec, Canada with a first-ever work-up for suspected PE in the emergency department (ED) over 10years were included. Patients could transition to outpatient management and from unconfirmed to confirmed PE in a time-varying fashion...
November 6, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29132369/impact-of-pharmacist-led-medication-management-in-care-transitions
#16
Seungwon Yang
BACKGROUND: When patients are discharged from hospital to home, it is a highlighted vulnerable period for which medication - related problems are prevalent. Researchers have proposed a telephone follow-up intervention as a means to reduce hospital readmissions. However, the outcome of the intervention with the engagement of pharmacists in managing patients' medicines after discharge has not been well explored. The objectives of this study were (1) to determine whether a pharmacist telephone follow-up intervention focusing on patients' medicines management support is associated with a reduction in 30-day readmission rates and (2) to describe the number and types of pharmacist interventions in care transitions...
November 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29131897/comparison-of-hospital-resource-use-and-outcomes-among-hospitalists-primary-care-physicians-and-other-generalists
#17
Jennifer P Stevens, David J Nyweide, Sha Maresh, Laura A Hatfield, Michael D Howell, Bruce E Landon
Importance: A physician's prior experience caring for a patient may be associated with patient outcomes and care patterns during and after hospitalization. Objective: To examine differences in the use of health care resources and outcomes among hospitalized patients cared for by hospitalists, their own primary care physicians (PCPs), or other generalists. Design, Setting, and participants: This retrospective study analyzed admissions for the 20 most common medical diagnoses among elderly fee-for-service Medicare patients from January 1 through December 31, 2013...
November 13, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29131896/association-of-coded-severity-with-readmission-reduction-after-the-hospital-readmissions-reduction-program
#18
Andrew M Ibrahim, Justin B Dimick, Shashank S Sinha, John M Hollingsworth, Ushapoorna Nuliyalu, Andrew M Ryan
No abstract text is available yet for this article.
November 13, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29131450/potential-for-health-care-cost-savings-with-preoperative-gastrostomy-tube-placement-in-the-head-and-neck-cancer-population
#19
Ashley C Mays, Harrison G Bartels, Paul R Wistermayer, Matt L Rohlfing, Christopher M Gentile, Ralph D'Agostino, Joshua D Waltonen
BACKGROUND: The purpose of this study was to examine the cost differences between preoperative and postoperative placement of gastrostomy tubes (G-tubes) in patients with head and neck cancer. METHODS: We conducted a retrospective chart review of patients with aerodigestive tract cancers from 2010 to 2015. Data included inpatient and postdischarge costs, demographics, tumor characteristics, surgical treatment, length of stay (LOS), time spent in the intensive care unit (ICU), and readmissions...
November 13, 2017: Head & Neck
https://www.readbyqxmd.com/read/29131098/implementation-of-a-new-high-volume-circular-stapler-in-stapled-anopexy-for-hemorrhoidal-disease-is-patient-s-short-term-outcome-affected-by-a-higher-volume-of-resected-tissue
#20
Brechtje A Grotenhuis, Joost Nonner, Eelco J R de Graaf, Pascal G Doornebosch
BACKGROUND: Stapled anopexy is a safe technique for the treatment of hemorrhoids but carries a higher risk of recurrence, which might be caused due to the limited volume of resected tissue. In this study, we investigated the introduction of a high-volume circular stapling device; in particular whether an increased amount of resected tissue could affect patients' short-term postoperative outcome. METHODS: Between 2011 and 2015, stapled anopexy was performed for hemorrhoids and/or anal prolapse in 141 patients (n = 25 conventional PPH-3©-stapler versus n = 116 high-volume CHEX©-stapler)...
November 2, 2017: Digestive Surgery
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