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https://www.readbyqxmd.com/read/28488237/perioperative-bleeding-and-thrombotic-risks-in-patients-with-von-willebrand-disease
#1
Nathaniel R Smilowitz, Navdeep Gupta, Yu Guo, Sripal Bangalore, Jeffrey S Berger
Von Willebrand disease (VWD) is an inherited bleeding disorder that often manifests clinically with hemorrhage after invasive procedures. We investigated the association between a diagnosis of VWD and bleeding and thrombotic outcomes following major non-cardiac surgery in a large national database from the United States. Patients age ≥45 years requiring major non-cardiac surgery were identified from Healthcare Cost and Utilization Project's National Inpatient Sample data. Von Willebrand disease, perioperative major adverse cardiovascular events (MACE), thrombotic events, and hemorrhage were defined by ICD9 diagnosis codes...
May 9, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28469696/hospital-days-attributable-to-immune-reconstitution-inflammatory-syndrome-in-persons-living-with-hiv-before-and-after-the-2012-dhhs-hiv-guidelines
#2
Peter Liu, Rebecca Dillingham, Kathleen McManus
BACKGROUND: Immune reconstitution inflammatory syndrome (IRIS) can manifest with initiation or reintroduction of antiretroviral therapy (ART) in persons living with HIV (PLWH). In 2012, updated United States treatment guidelines recommended initiation of ART for all PLWH regardless of CD4 count. The objectives of this study were to quantify hospital usage attributable to IRIS and assess the reasons for hospitalization in PLWH before and after the guideline update. METHODS: Subjects were PLWH between 18-89 years of age who were hospitalized between November 1, 2009 and July 31, 2014...
2017: AIDS Research and Therapy
https://www.readbyqxmd.com/read/28464903/hospital-days-attributable-to-immune-reconstitution-inflammatory-syndrome-in-persons-living-with-hiv-before-and-after-the-2012-dhhs-hiv-guidelines
#3
Peter Liu, Rebecca Dillingham, Kathleen McManus
BACKGROUND: Immune reconstitution inflammatory syndrome (IRIS) can manifest with initiation or reintroduction of antiretroviral therapy (ART) in persons living with HIV (PLWH). In 2012, updated United States treatment guidelines recommended initiation of ART for all PLWH regardless of CD4 count. The objectives of this study were to quantify hospital usage attributable to IRIS and assess the reasons for hospitalization in PLWH before and after the guideline update. METHODS: Subjects were PLWH between 18-89 years of age who were hospitalized between November 1, 2009 and July 31, 2014...
May 2, 2017: AIDS Research and Therapy
https://www.readbyqxmd.com/read/28450063/diverticulitis-diagnosed-in-the-emergency-room-is-it-safe-to-discharge-home
#4
Anne-Marie E Sirany, Wolfgang B Gaertner, Robert D Madoff, Mary R Kwaan
BACKGROUND: Inpatient treatment of patients with colon diverticulitis represents a significant financial and clinical burden to the healthcare system and patients. The aim of this study was compare patients with diverticulitis in the emergency department (ED) who were discharged to home versus admitted to the hospital. STUDY DESIGN: We reviewed all patients evaluated in the ED of a metropolitan health system with the primary diagnosis of diverticulitis (ICD9 562...
March 7, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28438417/comparing-hospital-outcomes-between-open-and-closed-tibia-fractures-treated-with-intramedullary-fixation
#5
Evan J Smith, Xiangyu Kuang, Rajeev Pandarinath
INTRODUCTION: Tibial shaft fractures comprise a large portion of operatively treated long bone fractures, and present with the highest rate of open injuries. Intramedullary fixation has become the standard of care for both open and closed injuries. The rates of short term complications and hospital length of stay for open and closed fractures treated with intramedullary fixation is not fully known. Previous series on tibia fractures were performed at high volume centers, and data were not generalizable, further they did not report on length of stay and the impact of preoperative variables on infections, complications and reoperation...
March 30, 2017: Injury
https://www.readbyqxmd.com/read/28434102/outcomes-following-surgical-management-of-cauda-equina-syndrome-does-race-matter
#6
Amit Jain, Emmanuel Menga, Addisu Mesfin
Cauda equina syndrome (CES) is a surgical emergency requiring urgent spinal decompression. Our objective is to analyze the association between race and in-hospital outcomes (complications, mortality, length of stay, and discharge disposition) in patients with CES. This is a retrospective cohort study of CES patients identified via the Nationwide Inpatient Sample (NIS) from 2000 to 2010 in inpatient hospitalizations in the USA. The patient sample includes 46,017 patients ≥18 undergoing spine surgery for CES...
April 21, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28431409/outcomes-of-hemiarthroplasty-and-total-hip-arthroplasty-for-femoral-neck-fracture-a-medicare-cohort-study
#7
Zhong Wang, Timothy Bhattacharyya
OBJECTIVES: For patients with femoral neck fractures, total hip arthroplasty (THA) demonstrates superior outcomes compared with hemiarthroplasty. However, hemiarthroplasty remains a common treatment for femoral neck fractures and the conversion rates are unknown. We compared the results of the 2 procedures using a Medicare database. METHODS: We assembled a cohort of 70,242 patients 65 to 90 years of age with an ICD9 diagnosis and matching Current Procedure Terminology code for femoral neck fracture between 2008 and 2012...
May 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28419189/propensity-scores-with-misclassified-treatment-assignment-a-likelihood-based-adjustment
#8
Danielle Braun, Malka Gorfine, Giovanni Parmigiani, Nils D Arvold, Francesca Dominici, Corwin Zigler
Propensity score methods are widely used in comparative effectiveness research using claims data. In this context, the inaccuracy of procedural or billing codes in claims data frequently misclassifies patients into treatment groups, that is, the treatment assignment ($T$) is often measured with error. In the context of a validation data where treatment assignment is accurate, we show that misclassification of treatment assignment can impact three distinct stages of a propensity score analysis: (i) propensity score estimation; (ii) propensity score implementation; and (iii) outcome analysis conducted conditional on the estimated propensity score and its implementation...
April 17, 2017: Biostatistics
https://www.readbyqxmd.com/read/28381294/decline-in-hospitalization-for-genital-warts-in-the-veneto-region-after-an-hpv-vaccination-program-an-observational-study
#9
Silvia Cocchio, Tatjana Baldovin, Chiara Bertoncello, Alessandra Buja, Patrizia Furlan, Mario Saia, Vincenzo Baldo
BACKGROUND: Human papillomavirus (HPV) is one of the most common sexually transmitted pathogens. This observational study was conducted to estimate the trend of hospitalization for genital warts (GWs) in the Veneto region (Italy) from 2004 to 2015. METHODS: All patients with GWs were identified in the hospital discharge records of all public and accredited private hospitals that related to Veneto residents and contained the ICD9-CM code 078.11 associated with a genital surgical procedure (vulval/vaginal warts, penile warts and anal warts)...
April 5, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28376563/the-effect-of-access-to-electronic-health-records-on-throughput-efficiency-and-imaging-utilization-in-the-emergency-department
#10
Matthew M Knepper, Edward M Castillo, Theodore C Chan, David A Guss
STUDY OBJECTIVE: To evaluate whether the availability of Electronic Health Records (EHRs) reduces throughput time and utilization of advanced imaging for patients in an academic ED. DATA SOURCES: All patients arriving at an academic Emergency Department (ED) via ambulance between June 1, 2011, and June 4, 2012, were included in the study. This accounted for 9,970 unique ambulance patient visits. STUDY DESIGN: Retrospective noninterventional analysis of patients in an academic ED...
April 4, 2017: Health Services Research
https://www.readbyqxmd.com/read/28368919/a-national-perspective-on-ecmo-utilization-in-patients-with-burn-injury
#11
Lauren B Nosanov, Melissa M McLawhorn, Mariana Vigiola Cruz, Jason H Chen, Jeffrey W Shupp
Extracorporeal membranous oxygenation (ECMO) has become an increasingly utilized strategy to support patients in cardiac and cardiopulmonary failure. The Extracorporeal Life Support Organization reports adult survival rates between 40 and 50%. Utilization and outcomes for burned patients undergoing ECMO are poorly understood. The National Burn Repository (version 8.0) was queried for patients with ICD9 procedure codes for ECMO. Demographics, comorbidities, mechanism, injury details, and clinical outcomes were recorded...
March 31, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28293491/disparities-in-utilization-of-jaw-surgery-for-treatment-of-sleep-apnea-a-nationwide-analysis
#12
Ravi K Garg, Ying Shan, Jeffrey A Havlena, Ahmed M Afifi
BACKGROUND: Maxillomandibular advancement has been shown to be one of the most effective operations for management of severe obstructive sleep apnea, yet pharyngeal surgery is more commonly performed. The goal of this study was to identify socioeconomic factors associated with this phenomenon. METHODS: Patients aged 14 or older with a primary hospital diagnosis of sleep apnea were identified using the National Inpatient Sample from 2005 to 2012. ICD9 codes were used to determine whether a pharyngeal or jaw procedure was performed...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28270107/incidence-of-cardiovascular-events-and-associated-risk-factors-in-kidney-transplant-patients-a-competing-risks-survival-analysis
#13
María Teresa Seoane-Pillado, Salvador Pita-Fernández, Francisco Valdés-Cañedo, Rocio Seijo-Bestilleiro, Sonia Pértega-Díaz, Constantino Fernández-Rivera, Ángel Alonso-Hernández, Cristina González-Martín, Vanesa Balboa-Barreiro
BACKGROUND: The high prevalence of cardiovascular risk factors among the renal transplant population accounts for increased mortality. The aim of this study is to determine the incidence of cardiovascular events and factors associated with cardiovascular events in these patients. METHODS: An observational ambispective follow-up study of renal transplant recipients (n = 2029) in the health district of A Coruña (Spain) during the period 1981-2011 was completed...
March 7, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28263146/chordae-tendineae-rupture-in-the-united-states-trends-of-outcomes-costs-and-surgical-interventions
#14
Elena V Dolmatova, Kasra Moazzami, James Maher, Marc Klapholz, Justin Sambol, Alfonso H Waller
OBJECTIVES: To describe national trends in the incidence and outcomes of patients with chordae tendineae rupture (CTR). METHODS: Patients who were diagnosed with CTR between 2000 and 2012 were identified in National (Nationwide) Inpatient Sample (NIS) registry. CTR was defined using validated International Classification of Diseases, 9th Edition, Clinical Modification diagnosis (ICD9-CM) codes. Results: A total of 37,287 (14,833 mitral valve repair, 7780 mitral valve replacement) CTR cases were identified...
February 27, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28259562/30-year-trends-in-admission-rates-for-encephalitis-in-children-in-england-and-effect-of-improved-diagnostics-and-measles-mumps-rubella-vaccination-a-population-based-observational-study
#15
Mildred A Iro, Manish Sadarangani, Raphael Goldacre, Alecia Nickless, Andrew J Pollard, Michael J Goldacre
BACKGROUND: Encephalitis is a serious neurological disorder, yet data on admission rates for all-cause childhood encephalitis in England are scarce. We aimed to estimate admission rates for childhood encephalitis in England over 33 years (1979-2011), to describe trends in admission rates, and to observe how these rates have varied with the introduction of vaccines and improved diagnostics. METHODS: We did a retrospective analysis of hospital admission statistics for encephalitis for individuals aged 0-19 years using national data from the Hospital Inpatient Enquiry (HIPE, 1979-85) and Hospital Episode Statistics (HES, 1990-2011)...
April 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28241760/early-recognition-of-multiple-sclerosis-using-natural-language-processing-of-the-electronic-health-record
#16
Herbert S Chase, Lindsey R Mitrani, Gabriel G Lu, Dominick J Fulgieri
BACKGROUND: Diagnostic accuracy might be improved by algorithms that searched patients' clinical notes in the electronic health record (EHR) for signs and symptoms of diseases such as multiple sclerosis (MS). The focus this study was to determine if patients with MS could be identified from their clinical notes prior to the initial recognition by their healthcare providers. METHODS: An MS-enriched cohort of patients with well-established MS (n = 165) and controls (n = 545), was generated from the adult outpatient clinic...
February 28, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28187074/epidemiologic-and-economic-burden-attributable-to-first-spinal-fusion-surgery-analysis-from-an-italian-administrative-database
#17
Paolo A Cortesi, Roberto Assietti, Fabrizio Cuzzocrea, Domenico Prestamburgo, Mauro Pluderi, Paolo Cozzolino, Patrizia Tito, Roberto Vanelli, Davide Cecconi, Stefano Borsa, Giancarlo Cesana, Lorenzo G Mantovani
STUDY DESIGN: Retrospective large population based-study OBJECTIVE.: Assessment of the epidemiologic trends and economic burden of first spinal fusions. SUMMARY OF BACKGROUND DATA: No adequate data are available regarding the epidemiology of spinal fusion surgery and its economic impact in Europe. METHODS: The study population was identified through a data warehouse (DENALI), which matches clinical and economic data of different Healthcare Administrative databases of the Italian Lombardy Region...
February 9, 2017: Spine
https://www.readbyqxmd.com/read/28185319/gabapentenoids-in-pain-management-in-urological-chronic-pelvic-pain-syndrome-gabapentin-or-pregabalin
#18
Mayank Mohan Agarwal, Mudelin Elsi Sy
AIMS: To compare efficacy of gabapentin and pregabalin in patients with urological chronic pelvic-pain syndrome (UCPPS). METHODS: Design-retrospective, setting-urology outpatient services of a secondary-care private hospital, inclusion criteria-men 18-50 years, presenting with pelvic pain (lower abdomen, groin, scrotum, perineum, low-back, hip) with or without lower urinary tract symptoms for at least 3 months duration. Hospital database was searched using keywords for neuropathic pain (ICD9-729...
February 10, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28152740/understanding-efficiency-of-chemotherapy-delivery-for-planned-chemotherapy-admission-at-columbia-university-medical-center
#19
Jason Dennis Wright, Sowmya Vasan, Alfred I Neugut, Jim Hu, Dawn L Hershman
206 Background: Delays in administration of planned in-patient chemotherapy can lead to prolonged length of stay (LOS), resulting in increased cost and risk of nosocomial infections and other complications. METHODS: We conducted a retrospective analysis of cancer patients admitted to Columbia University Medical Center, a tertiary care center, for planned chemotherapy from January 1, 2014 through December 31, 2014. Eligible patients were identified as cancer patients (via ICD9 codes) who were admitted directly to the inpatient hematology/oncology service with intravenous chemotherapy orders submitted within 24 hours of the admission...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152688/a-new-digital-classification-schema-to-detect-treatment-variances-and-enable-value-based-payment-reforms
#20
Eric V Schultz, Kelly Choi, William Kea, Augie Smith, Cindy Kim, Matthew Axelrod, Teresa Fletcher, Matthew Love, Ruth Pe Benito, Samira Daswani, Sukhi Kaur, Kathyrn Tanenbaum, James Schaffer, Ali Hasan, Dilip Raj, Kumar Bharath Prabhu, Kiran Suryadevara, Ryan Callahan, Stuart L Goldberg
28 Background: Value based payment reforms which improve the outcome to cost ratio (paying for outcomes not for services) require detailed information on both elements. Although the digitalization of medicine via the EHR may facilitate data collection, the imprecise ICD9 and ICD10 schemas hinder analysis (eg: all breast cancers are ICD9 174.9). A more precise classification schema that accounts for biologic variances to allow analysis (and reduction) of treatment variances is needed. METHODS: We have developed a digital classification (COTA Nodal Address) based on known clinically relevant prognostic variables...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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