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https://www.readbyqxmd.com/read/29332302/preoperative-cognitive-impairment-as-a-predictor-of-postoperative-outcomes-in-a-collaborative-care-model
#1
Kahli Zietlow, Shelley R McDonald, Richard Sloane, Jeffrey Browndyke, Sandhya Lagoo-Deenadayalan, Mitchell T Heflin
OBJECTIVES: To compare postoperative outcomes of individuals with and without cognitive impairment enrolled in the Perioperative Optimization of Senior Health (POSH) program at Duke University, a comanagement model involving surgery, anesthesia, and geriatrics. DESIGN: Retrospective analysis of individuals enrolled in a quality improvement program. SETTING: Tertiary academic center. PARTICIPANTS: Older adults undergoing surgery and referred to POSH (N = 157)...
January 13, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29331978/postdischarge-service-utilisation-and-outcomes-among-chinese-and-south-asian-psychiatric-inpatients-in-ontario-canada-a-population-based-cohort-study
#2
Maria Chiu, Evgenia Gatov, Juveria Zaheer, Michael Lebenbaum, Longdi Fu, Alice Newman, Paul Kurdyak
OBJECTIVE: We sought to examine the short-term and long-term impacts of psychiatric hospitalisations among patients of Chinese and South Asian origin. DESIGN: Retrospective population-based cohort study using linked health administrative data. SETTING: We examined all adult psychiatric inpatients discharged between 1 April 2006 and 31 March 2014 in Ontario, Canada, who were classified as Chinese, South Asian and all other ethnicities (ie, 'general population') using a validated algorithm...
January 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/29331355/contemporary-procedural-complications-hospitalizations-and-emergency-visits-after-catheter-ablation-for-atrial-fibrillation
#3
James V Freeman, Grace H Tabada, Kristi Reynolds, Sue Hee Sung, Taylor I Liu, Nigel Gupta, Alan S Go
Contemporary data on complications and resource utilization after atrial fibrillation (AF) ablation are limited. We evaluated rates and risk factors for procedural complication, rehospitalization, and emergency department visits after AF ablation. We identified all adult patients who underwent isolated AF ablation between 2010 and June 2014 in 2 large integrated health-care delivery systems and evaluated rates of acute inpatient complication, 30-day, and 1-year readmission and emergency evaluation. We used multivariable logistic regression to identify predictors of procedural complications, 30-day readmission, or 30-day emergency department evaluation...
December 14, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29331217/the-cost-of-perioperative-complications-following-pancreaticoduodenectomy-a-systematic-review
#4
REVIEW
Jason Wang, Ronald Ma, Leonid Churilov, Paul Eleftheriou, Mehrdad Nikfarjam, Christopher Christophi, Laurence Weinberg
BACKGROUND/OBJECTIVES: Pancreaticoduodenectomy (PD), also known as a Whipple procedure, is commonly performed for a variety of benign and malignant tumours, including of the pancreatic head and surrounding structures. PD is associated with low mortality but high morbidity and costs. Our objective was to describe the financial burden of complications following pancreaticoduodenectomy. METHODS: We searched for articles using the MEDLINE, EMBASE, Cochrane and EconLit databases from the year 2000...
December 19, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/29330739/patterns-and-outcomes-of-prescribing-venous-thromboembolism-prophylaxis-in-hospitalized-older-adults-a-retrospective-cohort-study
#5
Mark Goldin, Jessica Cohen, Alex Makhnevich, Colm Mulvany, Meredith Akerman, Liron Sinvani
Venous thromboembolism (VTE) is a major cause of morbidity and mortality in the United States. Hospitalized, medically ill older adults have increased risk; despite guidelines, data suggest suboptimal pharmacologic prophylaxis rates. Factors influencing provider prescribing non-compliance are unclear. We aimed to describe VTE prophylaxis practices and identify risk factors for, and outcomes of, prescribing non-compliance. A retrospective study was conducted of hospitalized adults aged ≥ 75 years, admitted to the medicine service of a large academic tertiary center from May 1, 2014 to June 30, 2015...
January 12, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29329893/effect-of-short-and-long-term-diabetes-control-on-in-hospital-and-one-year-mortality-rates-in-hospitalized-patients-with-diabetic-foot
#6
Z Feldbrin, M Shargorodsky, J Wainstein, D Melnikov, G Zandman-Goddard
INTRODUCTION: It remains unclear whether diabetic patients with diabetic foot complications benefit from strict glycemic control during hospitalization The present study investigates the effect of short- and long-term diabetes control on hospital outcomes including: in-hospital and one year mortality rates, length of hospital stay and the rate of repeated admissions. METHODS: Type 2 diabetic patients (n = 341) were hospitalized for diabetic foot complications at Wolfson Medical Center over a 5 year period (2008-2012)...
January 9, 2018: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29329802/can-use-of-an-administrative-database-improve-accuracy-of-hospital-reported-readmission-rates
#7
James R Edgerton, Morley A Herbert, Baron L Hamman, W Steves Ring
OBJECTIVES: Readmission rates after cardiac surgery are being used as a quality indicator; they are also being collected by Medicare and are tied to reimbursement. Accurate knowledge of readmission rates may be difficult to achieve because patients may be readmitted to different hospitals. In our area, 81 hospitals share administrative claims data; 28 of these hospitals (from 5 different hospital systems) do cardiac surgery and share Society of Thoracic Surgeons (STS) clinical data. We used these 2 sources to compare the readmissions data for accuracy...
December 5, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29329664/the-impact-of-mental-health-disorders-on-30-day-readmission-after-bariatric-surgery
#8
Megan Litz, Andrea Rigby, Ann M Rogers, Douglas L Leslie, Christopher S Hollenbeak
BACKGROUND: Mental health disorders are common among bariatric surgery patients. Mental health disorders, particularly depression, have been associated with poorer surgical outcomes, indicating the bariatric surgery patient population warrants special clinical attention. OBJECTIVE: Our study sought to examine the effect of diagnosed mental health disorders on 30-day readmission for those undergoing bariatric surgery in hospitals across Pennsylvania from 2011 to 2014...
December 8, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29329508/hospital-readmissions-and-the-day-of-the-week
#9
Aman Verma, Christian Rochefort, Guido Powell, David Buckeridge
Objectives Patients discharged from hospitals on a Friday (Friday discharges) are readmitted sooner (a shorter time-to-emergency-readmission) than those discharged on any other day of the week. To evaluate the cost-effectiveness of increasing weekend capacity, the effect estimate of Friday discharge on time-to-emergency-readmission needs to be precise. However, precise effect estimation is complicated by the confounding effect of differing healthcare-seeking behaviour and admission practices, and therefore different admission probability, by day of the week...
January 2018: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/29329165/repeat-rapid-response-events-in-children-characteristics-and-outcomes
#10
Kristen M Meulmester, Nancy Jaimon, Aarti C Bavare
OBJECTIVE: We describe the characteristics and outcomes of pediatric repeat rapid response events within a single hospitalization. We hypothesized that triggers for repeat rapid response and initial rapid response events are similar, and repeat rapid response events are associated with high prevalence of medical complexity and worse outcomes. DESIGN: A 3-year retrospective study. SETTING: High-volume tertiary academic pediatric hospital. PATIENTS: All rapid response events were reviewed to identify repeat rapid response events...
January 11, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29327310/c-reactive-protein-on-postoperative-day-1-is-a-reliable-predictor-of-pancreas-specific-complications-after-pancreaticoduodenectomy
#11
Théophile Guilbaud, David Jérémie Birnbaum, Coralie Lemoine, Mircea Chirica, Olivier Risse, Stéphane Berdah, Edouard Girard, Vincent Moutardier
BACKGROUND: Postoperative pancreatic fistula and pancreas-specific complications have a significant influence on patient management and outcomes after pancreatoduodenectomy. The aim of the study was to assess the value of serum C-reactive protein on the postoperative day 1 as early predictor of pancreatic fistula and pancreas-specific complications. METHODS: Between 2013 and 2016, 110 patients underwent pancreaticoduodenectomy. Clinical, biological, intraoperative, and pathological characteristics were prospectively recorded...
January 4, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29327276/portal-congestion-and-intestinal-edema-in-hospitalized-patients-with-heart-failure
#12
Yuki Ikeda, Shunsuke Ishii, Mayu Yazaki, Teppei Fujita, Yuichiro Iida, Toyoji Kaida, Takeru Nabeta, Eiji Nakatani, Emi Maekawa, Tomoyoshi Yanagisawa, Toshimi Koitabashi, Takayuki Inomata, Junya Ako
An interaction between the intestine and cardiovascular disease has been suggested. We thought to clarify the association between intestinal conditions and clinical outcomes in patients with heart failure (HF). Hemodynamic parameters in intestinal vessels [superior mesenteric artery (SMA), inferior mesenteric artery (IMA), and portal vein (PV)] and average colon wall thickness (aCWT) from the ascending colon to sigmoid colon were evaluated in 224 hospitalized HF patients. Echocardiographic parameters and composite event rates (all-cause mortality, readmission for HF deterioration, major ventricular arrhythmias) were also examined...
January 11, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29327120/readmission-and-reoperation-after-midurethral-sling
#13
Erik D Hokenstad, Amy E Glasgow, Elizabeth B Habermann, John A Occhino
INTRODUCTION AND HYPOTHESIS: We aimed to determine the rate of readmission and reoperation for patients undergoing midurethral sling (MUS) placement for stress urinary incontinence (SUI). METHODS: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was queried to identify all isolated MUS placed from 2012 through 2015 using the Current Procedural Terminology 4 (CPT-4) code for MUS with or without cystoscopy (57,288 ± 52,000)...
January 11, 2018: International Urogynecology Journal
https://www.readbyqxmd.com/read/29326183/transvaginal-natural-orifice-transluminal-endoscopic-surgery-vnotes-adnexectomy-for-benign-pathology-compared-with-laparoscopic-excision-notable-a-protocol-for-a-randomised-controlled-trial
#14
Jan Filip Baekelandt, Peter A De Mulder, Ilse Le Roy, Chantal Mathieu, Annouschka Laenen, Paul Enzlin, Steven Weyers, Ben W J Mol, Jan J A Bosteels
INTRODUCTION: Natural orifice transluminal endoscopic surgery (NOTES) uses natural orifices to access the cavities of the human body to perform surgical interventions. NOTES limits the magnitude of surgical trauma and potentially reduces postoperative pain. Our group published a protocol on a randomised study comparing transvaginal NOTES (vNOTES) versus laparoscopy for hysterectomy (HALON). We simultaneously designed a similar randomised controlled trial (RCT) comparing vNOTES with laparoscopy for adnexectomy...
January 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29326108/short-term-risk-of-cardiovascular-readmission-following-a-hypertensive-disorder-of-pregnancy
#15
Jennifer L Jarvie, Torri D Metz, Melinda B Davis, Jessica C Ehrig, David P Kao
OBJECTIVE: Women with pregnancies complicated by hypertensive disorders of pregnancy (HDP) have increased long-term cardiovascular (CV) risk. We sought to determine if they demonstrate increased short-term CV risk. METHODS: Using administrative records, all hospital-based deliveries in Florida from 2004 to 2010 and subsequent readmission to any Florida hospital within 3 years of index delivery were identified. Deliveries and clinical diagnoses were determined using International Classification of Diseases, Ninth Revision, Clinical Modification codes...
January 11, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29325786/a-proactive-outreach-intervention-that-decreases-readmission-after-hepatectomy
#16
Nisha Narula, Bradford J Kim, Catherine H Davis, Whitney L Dewhurst, Leigh A Samp, Thomas A Aloia
BACKGROUND: After hepatectomy, 7%-19% of patients are readmitted within 30 days, accounting for substantial cost and poor patient experience. The purpose of this study was to analyze the impact of a proactive outreach intervention on readmissions. METHODS: Consecutive patients undergoing hepatectomy by a single surgeon 2012-2016 were identified in a prospectively maintained database. In August 2013 a postoperative intervention was implemented; an advanced practice provider called each patient within 72 hours of discharge...
January 9, 2018: Surgery
https://www.readbyqxmd.com/read/29325583/an-integrated-delivery-of-care-approach-to-improve-patient-reported-physical-function-and-mental-wellbeing-after-orthopedic-trauma-study-protocol-for-a-randomized-controlled-trial
#17
Laura Zdziarski-Horodyski, MaryBeth Horodyski, Kalia K Sadasivan, Jennifer Hagen, Terrie Vasilopoulos, Matthew Patrick, Robert Guenther, Heather K Vincent
BACKGROUND: Orthopedic trauma injury impacts nearly 2.8 million people each year. Despite surgical improvements and excellent survivorship rates, many patients experience poor quality of life (QOL) outcomes years later. Psychological distress commonly occurs after injury. Distressed patients more frequently experience rehospitalizations, pain medication dependence, and low QOL. This study was developed to test whether an integrative care approach (IntCare; ten-step program of emotional support, education, customized resources, and medical care) was superior to usual care (UsCare)...
January 11, 2018: Trials
https://www.readbyqxmd.com/read/29324773/the-impact-of-a-short-term-cohousing-initiative-among-schizophrenia-patients-high-school-students-and-their-social-context-a-qualitative-case-study
#18
Domingo Palacios-Ceña, Emilio Andrés Martín-Tejedor, Ana Elías-Elispuru, Amaia Garate-Samaniego, Jorge Pérez-Corrales, Elena García-García
BACKGROUND: A number of programs have been developed to promote the contact between adolescents and mentally-ill patients, in order to break the stigma, improve understanding, promote mental health and prevent substance abuse. The aim of this study was to describe the experience of patients with schizophrenia, high school students, and their social context, participating in a short-term cohousing initiative. METHODS: A qualitative case-study approach was implemented...
2018: PloS One
https://www.readbyqxmd.com/read/29324598/adoption-of-minimally-invasive-surgery-and-decrease-in-surgical-morbidity-for-endometrial-cancer-treatment-in-the-united-states
#19
Jvan Casarin, Francesco Multinu, Daniel S Ubl, Sean C Dowdy, William A Cliby, Gretchen E Glaser, Kristina A Butler, Fabio Ghezzi, Elizabeth B Habermann, Andrea Mariani
OBJECTIVE: To assess how the widespread adoption of minimally invasive surgery in the United States is associated with changes in 30-day morbidity and mortality in endometrial cancer treatment. METHODS: In this retrospective cohort study, the American College of Surgeons' National Surgical Quality Improvement Project database for 2008-2014 was reviewed for patients who had undergone surgery for endometrial cancer according to their primary Current Procedural Terminology (CPT) codes...
January 9, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29324582/quality-measures-in-acute-kidney-injury
#20
Amjad Mehboob, Robert Zimmerman, Stuart Abramson, Mark G Parker
PURPOSE OF REVIEW: Quality measure assessment and reporting is evolving in end-stage renal disease care and is inchoate in ambulatory nephrology clinic care. Acute kidney injury (AKI) quality measures have not received sufficient attention, yet deserve consideration in view of the substantial proportion of effort nephrology providers devote to AKI care. RECENT FINDINGS: Accumulating literature permits consideration of timing of nephrology consultation, follow-up after AKI hospitalization, early detection, medication dosing, hospital readmissions and length of stay, cost, and mortality as putative AKI quality measures...
January 10, 2018: Current Opinion in Nephrology and Hypertension
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