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F J Murcia Pascual, J I Garrido Pérez, V Vargas Cruz, J E Betancourth Alvarenga, M A Cárdenas Elías, F Vázquez Rueda, R M Paredes Esteban
OBJECTIVES: Currently the management of appendicular mass remains controversial. Many authors advocate conservative management followed by delayed appendectomy, whereas others favour inmediate appendectomy. The aim of our study is to compare both treatments. METHODS: A descriptive and observational study over 46 patients treated for appendiceal mass at our center in the last ten years was performed. Patients were categorized as group 1, early surgical intervention (54...
October 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Tonya Deen, Theresa Terna, Elizabeth Kim, Brian Leahy, Wende Fedder
PURPOSE: The purpose of this study was to describe the impact a Stroke Nurse Navigation Program has on concurrent chart reviews and patient compliance post discharge. DESIGN: Phase I: Concurrent chart review of The Joint Commission Primary Stroke Center core measures for ischemic stroke patients. Phase II: Longitudinal study of 100 ischemic stroke patients discharged to home. METHODS: Telephone surveys were conducted at prescribed intervals posthospital discharge (Phase II)...
October 24, 2016: Rehabilitation Nursing: the Official Journal of the Association of Rehabilitation Nurses
Ming Li, Wei Zhang, Li Jiang, Jiayin Yang, Lunan Yan
BACKGROUND: Liver resection (LR) is preferred treatment for malignancies or benign masses of liver. Using multiple elements, fast track (FT) program was introduced to abdominal surgery associating with fast functional recovery and shorter hospital length of stay (LoS). This meta-analysis aims to evaluate the effect of FT program for patients following liver resection. MATERIALS AND METHODS: We searched the PubMed/Medline, Cochrane Central Register of Controlled Trials (CENTRAL), Embase for trials up to December 2015 to compare the FT program to the conventional group...
October 20, 2016: International Journal of Surgery
Ram A Pathak, Gregory A Broderick, Todd C Igel, Steven P Petrou, Paul R Young, Michael J Wehle, Michael G Heckman, Nancy N Diehl, Emily R Vargas, Kandarp Shah, David D Thiel
OBJECTIVE: To compare the frequency of postoperative encounters in the 30-day and 90-day postoperative periods for various bladder outlet obstruction surgical therapies. METHODS: All patients who underwent transurethral resection of the prostate (TURP), GreenLight laser photovaporization of the prostate (GL-PVP) (American Medical Systems Inc.), and holmium laser enucleation of the prostate (HoLEP) from January 1(st), 2012 through December 31(st), 2014 were followed for 6 months postoperatively...
October 19, 2016: Urology
A Carmine Colavecchia, David R Putney, Michael L Johnson, Rajender R Aparasu
BACKGROUND: Limited research exists regarding Medication Regimen Complexity Index (MRCI) and its utility in identifying patients at risk for hospital readmission. OBJECTIVE: This study evaluates the association between discharge MRCI and 30-day rehospitalization in patients with heart failure (HF) after discharge. METHODS: The study involved a retrospective, cohort study at a large tertiary teaching facility from the University HealthSystem Consortium...
October 8, 2016: Research in Social & Administrative Pharmacy: RSAP
Jonathan S Abelson, Joshua D Spiegel, Cheguevara Afaneh, Jialin Mao, Art Sedrakyan, Heather L Yeo
BACKGROUND: Although there is a large body of published data demonstrating improved outcomes for complex operations when performed by high-volume surgeons at high-volume hospitals, the literature is mixed regarding whether this same relationship applies in less complex and more common surgeries such as laparoscopic cholecystectomy. METHODS: This study utilized the New York State Department of Health Statewide Planning and Research Cooperative System database to identify patients undergoing laparoscopic cholecystectomy for acute and chronic biliary pathology...
October 19, 2016: Surgery
Mark Brittan, Troy Richardson, Chén Kenyon, Marion Sills, Evan Fieldston, Matt Hall, David Fox, Samir Shah, Jay Berry
OBJECTIVES: To assess the relationships between postdischarge emergency department visits, oral corticosteroid (OCS) use, and 15- to 90-day asthma readmission in children. STUDY DESIGN: Retrospective study of 9288 children from 12 states in the Truven MarketScan Database, ages 2-18 years, hospitalized between January 1, 2009, and June 30, 2011, with asthma, and continuously enrolled in Medicaid for 6 months prior and 3 months after hospitalization. The primary outcome was 15- to 90-day readmission for asthma...
October 18, 2016: Journal of Pediatrics
George Kokosis, Zhifei Sun, Yash J Avashia, Mohamed A Adam, Howard Levinson, Detlev Erdmann, Christopher R Mantyh, John Migaly
BACKGROUND: The aim of this study was to compare wound complications from V-Y flap vs primary closure in the setting of abdominoperineal resection. METHODS: This was a single institution retrospective review (1999-2014). The main outcome measures were any wound complication, hospital length of stay, and unplanned readmissions. RESULTS: Among 80 patients included, 21 (26%) received reconstruction with V-Y flap. Compared with those who received primary closure, patients who underwent V-Y flap reconstruction had lower rates of overall wound complications (14...
July 21, 2016: American Journal of Surgery
Michael Maceroli, Lucas E Nikkel, Bilal Mahmood, John P Ketz, Xing Qiu, Joseph Ciminelli, Susan Messing, John C Elfar
OBJECTIVES: To determine if hospital arthroplasty volume affects patient outcomes after undergoing total hip arthroplasty (THA) for displaced femoral neck fractures. METHODS: The Statewide Planning and Research Cooperative System database from the New York State Department of Health was used to group hospitals into quartiles based on overall THA volume from 2000 to 2010. The database was then queried to identify all patients undergoing THA specifically for femoral neck fracture during this time period...
November 2016: Journal of Orthopaedic Trauma
Michael D Cusimano, Iryna Pshonyak, Michael Y Lee, Gabriela Ilie
OBJECTIVE The 30-day readmission rate has emerged as an important marker of the quality of in-hospital care in several fields of medicine. This review aims to summarize available research reporting readmission rates after cranial procedures and to establish an association with demographic, clinical, and system-related factors and clinical outcomes. METHODS The authors conducted a systematic review of several databases; a manual search of the Journal of Neurosurgery, Neurosurgery, Acta Neurochirurgica, Canadian Journal of Neurological Sciences; and the cited references of the selected articles...
October 21, 2016: Journal of Neurosurgery
Eugene Lin, Manjula Kurella Tamura, Maria E Montez-Rath, Glenn M Chertow
Introduction The use of administrative data to capture 30-day readmission rates in end-stage renal disease is challenging since Medicare combines claims from acute care, inpatient rehabilitation (IRF), and long-term care hospital stays into a single "Inpatient" file. For data prior to 2012, the United States Renal Data System does not contain the variables necessary to easily identify different facility types, making it likely that prior studies have inaccurately estimated 30-day readmission rates. Methods For this report, we developed two methods (a "simple method" and a "rehabilitation-adjusted method") to identify acute care, IRF, and long-term care hospital stays from United States Renal Data System claims data, and compared them to methods used in previously published reports...
October 20, 2016: Hemodialysis International
Michael P Thompson, Cameron M Kaplan, Yu Cao, Gloria J Bazzoli, Teresa M Waters
OBJECTIVE: To assess the reliability of risk-standardized readmission rates (RSRRs) for medical conditions and surgical procedures used in the Hospital Readmission Reduction Program (HRRP). DATA SOURCES: State Inpatient Databases for six states from 2011 to 2013 were used to identify patient cohorts for the six conditions used in the HRRP, which was augmented with hospital characteristic and HRRP penalty data. STUDY DESIGN: Hierarchical logistic regression models estimated hospital-level RSRRs for each condition, the reliability of each RSRR, and the extent to which socioeconomic and hospital factors further explain RSRR variation...
October 21, 2016: Health Services Research
Eric J Lammers, Catherine G McLaughlin, Michael Barna
OBJECTIVE: To test for correlation between the growth in adoption of ambulatory electronic health records (EHRs) in the United States during 2010-2013 and hospital admissions and readmissions for elderly Medicare beneficiaries with at least one of four common ambulatory care-sensitive conditions (ACSCs). DATA SOURCES: SK&A Information Services Survey of Physicians, American Hospital Association General Survey and Information Technology Supplement; and the Centers for Medicare & Medicaid Services Chronic Conditions Data Warehouse Geographic Variation Database for 2010 through 2013...
October 21, 2016: Health Services Research
Giuseppe Moscelli, Luigi Siciliani, Nils Gutacker, Hugh Gravelle
We investigate (a) how patient choice of hospital for elective hip replacement is influenced by distance, quality and waiting times, (b) differences in choices between patients in urban and rural locations, (c) the relationship between hospitals' elasticities of demand to quality and the number of local rivals, and how these changed after relaxation of constraints on hospital choice in England in 2006. Using a data set on over 500,000 elective hip replacement patients over the period 2002 to 2013 we find that patients became more likely to travel to a provider with higher quality or lower waiting times, the proportion of patients bypassing their nearest provider increased from 25% to almost 50%, and hospital elasticity of demand with respect to own quality increased...
September 2016: Regional Science and Urban Economics
Erika Roddy, Mohammad Diab
BACKGROUND CONTEXT: Short-term readmission rates are becoming widely utilized as a quality and performance metrics for hospitals. Data on unplanned short-term readmission after spine fusion for deformity in pædiatric patients is limited. PURPOSE: To characterize the rate and risk factors for short-term readmission after spine fusion for deformity in pædiatric patients. STUDY DESIGN: Retrospective cohort study PATIENT SAMPLE: State In-Patient Databases from NY, UT, NE, FL, NC (years 2006-2010) and CA (years 2006-2011)...
October 17, 2016: Spine Journal: Official Journal of the North American Spine Society
Matthew J Bream, Matthew J Maurice, Joshua Altschuler, Hui Zhu, Robert Abouassaly
OBJECTIVE: To assess national utilization patterns for cystectomy and non-surgical treatments for elderly patients with muscle-invasive bladder cancer (MIBC). MATERIALS AND METHODS: From the National Cancer Data Base (NCDB), we identified patients ≥75 years old with T2-T4, non-metastatic urothelial carcinoma between 2003 and 2012. Patients were grouped by treatment: cystectomy, chemoradiation, or non-standard treatment. Cochran-Armitage trend test was used to evaluate time trends for treatments and perioperative outcomes...
October 17, 2016: Urology
Annie L Nguyen, Tingjian Yan, Kathleen Ell, Jorge Gonzalez, Susan Enguidanos
OBJECTIVE: Latinos are disproportionately affected by diabetes and people with diabetes experience frequent hospital admissions and readmissions. Care transition interventions can help reduce rates of readmission; however, there are many barriers to recruiting Latinos for participation in intervention research. Exploring reasons for study refusal furthers understanding of low research participation rates to help researchers address barriers. DESIGN: This study presents a cross-sectional, descriptive analysis of reasons for study refusal and attrition drawing from data collected as part of a randomized controlled trial conducted to test the effectiveness of a transitions intervention for diabetic Latino discharged from the hospital to home...
October 21, 2016: Ethnicity & Health
Gabriella Di Domenico, Ivan Tersigni, Bruno Federico, Cinzia Leuter
: OBIETTIVI: determinare i fattori associati ai ricoveri ripetuti per identificare i pazienti a rischio di riospedalizzazione entro i 30 giorni dalla dimissione. DISEGNO: analisi retrospettiva delle dimissioni nell'anno 2013 attraverso le schede di dimissione ospedaliera (SDO). SETTING E PARTECIPANTI: 3.900 pazienti ricoverati presso il presidio ospedaliero "Fabrizio Spaziani" di Frosinone. PRINCIPALI MISURE DI OUTCOME: analisi bivariata per l'analisi dell'associazione tra variabili...
September 2016: Epidemiologia e Prevenzione
Sanath Allampati, Kevin D Mullen
Hepatic Encephalopathy (HE) is a complex neuropsychiatric syndrome associated with decompensated liver disease. The spectrum of disease ranges from trivial abnormalities in complex decision making and prolonged reaction time to coma in its most severe form1. The very initial stages, recently termed covert Hepatic Encephalopathy (CHE), can only be diagnosed with the help of neuropsychiatric testing while the later and more severe forms, termed overt Hepatic Encephalopathy (OHE), can be diagnosed clinically. Severity of HE is graded based on West Haven Criteria and please refer to table 1 for more details2...
October 20, 2016: Minerva Gastroenterologica e Dietologica
M J Lin, F Baky, B C Housley, N Kelly, E Pletcher, J D Balshi, S P Stawicki, D C Evans
INTRODUCTION: Clinical information continues to be limited regarding changes in the temporal risk profile for readmissions during the initial postoperative year in vascular surgery patients. We set out to describe the associations between demographics, clinical outcomes, comorbidity indices, and hospital readmissions in a sample of patients undergoing common extremity revascularization or dialysis access (ERDA) procedures. We hypothesized that factors independently associated with readmission will evolve from "short-term" to "long-term" determinants at 30-, 180-, and 360-day postoperative cutoff points...
October 2016: Journal of Postgraduate Medicine
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