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https://www.readbyqxmd.com/read/28937843/emergency-department-visits-for-postpartum-complications
#1
Erin Christine Brousseau, Valery Danilack, Fei Cai, Kristen A Matteson
INTRODUCTION: Most estimates of the prevalence and types of postpartum complications are based on hospital readmissions. However, using hospital readmissions (which occurs in only 1%-2% of postpartum women) is problematic as it fails to include women with postpartum complications assessed in the office or emergency department (ED). We utilized data from a cohort of women evaluated in an ED setting to better characterize complications experienced by women in the postpartum period. MATERIALS AND METHODS: We performed a retrospective analysis of all postpartum visits to the ED at a tertiary care women's hospital over 6 months...
September 22, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28936790/favorable-results-from-a-prospective-evaluation-of-200-patients-with-large-hiatal-hernias-undergoing-linx-magnetic-sphincter-augmentation
#2
F P Buckley, Reginald C W Bell, Kate Freeman, Stephanie Doggett, Rachel Heidrick
INTRODUCTION: Magnetic sphincter augmentation (MSA) of the lower esophageal sphincter restores the antireflux barrier in patients with hiatal hernias ≤3 cm. We performed a prospective study in patients undergoing MSA with the LINX device during repair of paraesophageal and hernias over 3 cm axial component. METHODS AND PROCEDURES: Multicenter, prospective study of consecutive patients treated with MSA at the time of repair of hiatal hernias >3 cm. RESULTS: 200 patients (110 female) were treated between March 2014 and February 2017 via laparoscopic hernia repair and MSA...
September 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28936138/prevalence-and-overlap-of-disease-management-program-diseases-in-older-hospitalized-patients
#3
Helle Gybel Juul-Larsen, Janne Petersen, Ditte Maria Sivertsen, Ove Andersen
Many countries, like Denmark, have tailored Disease Management Programs (DMPs) based on patients having single chronic diseases [defined institutionally as "program diseases" (PDs)], which can complicate treatment for those with multiple chronic diseases. The aims of this study were (a) to assess the prevalence and overlap among acutely hospitalized older medical patients of PDs defined by the DMPs, and (b) to examine transitions between different departments during hospitalization and mortality and readmission within two time intervals among patients with the different PDs...
September 2017: European Journal of Ageing
https://www.readbyqxmd.com/read/28935512/analysis-of-short-and-long-term-outcomes-of-patients-with-surgically-treated-left-sided-infective-endocarditis-a-5-year-longitudinal-follow-up-study
#4
Oksana Marushchak, Holy Cole, Brett Hiebert, Evelyn Lo, Yoav Keynan, James Tam, Nasir Shaikh, Alan H Menkis, Rakesh C Arora, Pallav Shah
This study aims to analyze survival, repeat hospitalization, and risk factors for surgically treated left-sided endocarditis. Retrospective review of all 166 (114 native and 52 prosthetic) patients operated between January 2004 and March 2015 was performed. Long-term survival and repeat hospitalization data for 134 of 166 patients were obtained via linked clinical databases with the Manitoba Centre for Health Policy. Kaplan-Meier estimates of survival and hospital readmission and Cox multivariable regression analysis of factors influencing outcomes were performed...
August 23, 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28935451/short-term-outcomes-following-hepatectomy-for-hepatocellular-carcinoma-within-and-beyond-the-bclc-guidelines-a-prospective-study
#5
Chetana Lim, Chady Salloum, Michael Osseis, Eylon Lahat, Imma G Gavara, Philippe Compagnon, Alain Luciani, Cyrille Feray, Daniel Azoulay
BACKGROUND: Western guidelines recommend resection for hepatocellular carcinoma (HCC) in so-called ideal cirrhotic patients with a Barcelona Clinic Liver Cancer (BCLC) stage 0-A tumour. This study compares short-term outcomes following resection between patients defined as ideal and nonideal according to the BCLC guidelines. METHODS: This prospective single-centre open study (ClinicalTrials.govNCT02145013) included all cirrhotic patients with HCC referred for resection from 2014 to 2016...
September 18, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28935348/outcomes-after-sleeve-lung-resections-versus-pneumonectomy-in-the-united-states
#6
Zaid M Abdelsattar, K Robert Shen, Sai Yendamuri, Stephen Cassivi, Francis C Nichols, Dennis A Wigle, Mark S Allen, Shanda H Blackmon
BACKGROUND: The current national trends, practice patterns, and outcomes after sleeve resection compared with pneumonectomy in the United States are not known. In addition, whether hospital sleeve-to-pneumonectomy (S:P) ratios are a valid marker of hospital quality is unclear. We describe practice patterns and evaluate the utility of the S:P ratio. METHODS: We identified all patients (N = 23,964) undergoing sleeve resection (n = 1,713) or pneumonectomy (n = 22,251) in the National Cancer Data Base between 1998 and 2012 at 644 hospitals...
September 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28934783/serious-adverse-events-associated-with-readmission-through-one-year-after-vertebral-augmentation-with-either-a-polyetheretherketone-implant-or-balloon-kyphoplasty
#7
Douglas P Beall, Jeffrey D Coe, Mark McIlduff, Daniel Bloch, John Hornberger, Christopher Warner, Sean Tutton
BACKGROUND: The KAST (Kiva Safety and Efficacy) investigation device exempt (IDE) study indicated that the majority of patients responded equally well to vertebral augmentation using either an implant-based approach or balloon kyphoplasty (BK). Additional investigation has suggested that a subset of patients may benefit further by avoiding repeated readmissions due to serious adverse events (SAEs) if they receive one vertebral augmentation approach over another. OBJECTIVES: The primary aim was to assess the effect of 2 different augmentation procedures on readmission rates for SAEs...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28933581/peak-inspiratory-flow-rate-in-chronic-obstructive-pulmonary-disease-implications-for-dry-powder-inhalers
#8
Sohini Ghosh, Jill A Ohar, M Bradley Drummond
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States with a significant economic burden related to hospital admissions for exacerbations. One of the primary treatment modalities for COPD is medications delivered through breath-actuated dry powdered inhalers (DPIs). For users to successfully receive inhaled medication, they must inhale with enough flow to overcome the internal resistance of the device, leading to deaggregation of the medication powder. Peak inspiratory flow rate (PIFR) is the maximal flow rate obtained during an inspiratory maneuver...
September 21, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28932722/the-first-year-after-colorectal-surgery-in-the-elderly
#9
Verena N N Kornmann, Jeroen L A van Vugt, Anke B Smits, Bert van Ramshorst, Djamila Boerma
PURPOSE: Surgery for colorectal malignancy is increasingly being performed in the elderly. Little is known about the impact of complications on late mortality. This study aimed to analyze whether a complicated postoperative course affects the 1-year survival in elderly patients. METHODS: All consecutive patients older than 75 years of age who underwent colorectal cancer surgery between January 2009 and April 2013 were included in this study. The main outcome was mortality at 1 year after surgery...
August 2017: Annals of Coloproctology
https://www.readbyqxmd.com/read/28932566/non-intubated-single-incision-video-assisted-thoracic-surgery-a-two-center-cohort-of-188-patients
#10
Man-Ling Wang, Carlos Galvez, Jin-Shing Chen, Jose Navarro-Martinez, Sergio Bolufer, Ming-Hui Hung, Hsao-Hsung Hsu, Ya-Jung Cheng
BACKGROUND: Non-intubated single-incision procedures are slowly expanding because of high experience and skill required, and stricter selection criteria. The aim of this study is to present the first retrospective two-center series in Taiwan and Spain. METHODS: We performed a retrospective analysis of 188 patients undergoing non-intubated single-incision video-assisted thoracic surgery (NI-SI-VATS) procedures between July 2013 to November 2015 in two centers in Taiwan (170 patients) and Spain (18 patients) with two different anesthetic methods...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28930833/readmission-due-to-infection-following-total-hip-and-total-knee-procedures-a-retrospective-study
#11
Nadine Zawadzki, Yao Wang, Hui Shao, Emelline Liu, Chao Song, Michele Schoonmaker, Lizheng Shi
Policymakers have expanded readmissions penalty programs to include elective arthroplasties, but little is known about the risk factors for readmissions following these procedures. We hypothesized that infections after total hip arthroplasty (THA) and total knee arthroplasty (TKA) lead to excess readmissions and increased costs. This study aims to evaluate the proportion of readmissions due to infections following THA and TKA.Healthcare Cost and Utilization Project-State Inpatient Databases were used for the study...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28929392/preventing-early-bouncebacks-to-the-neurointensive-care-unit-a-retrospective-analysis-and-quality-improvement-pilot
#12
David G Coughlin, Monisha A Kumar, Neha N Patel, Rebecca L Hoffman, Scott E Kasner
BACKGROUND: Early unplanned readmissions of "bouncebacks" to intensive care units are a healthcare quality metric and result in higher mortality and greater cost. Few studies have examined bouncebacks to the neurointensive care unit (neuro-ICU), and we sought to design and implement a quality improvement pilot to reduce that rate. METHODS: First, we performed a retrospective chart review of 504 transfers to identify potential bounceback risk factors. Risk factors were assessed on the day of transfer by the transferring physician identifying patients as "high risk" or "low risk" for bounceback...
September 19, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28927865/a-latent-class-analysis-of-brief-postpartum-psychiatric-hospital-admissions
#13
Inbal Shlomi Polachek, Kinwah Fung, Karen Putnam, Samantha Meltzer Brody, Simone N Vigod
Almost 40% of postpartum psychiatric hospital admissions are brief, lasting 72h or less. We aimed to identify unique subgroups of women within this group to inform better intervention. All women in Ontario, Canada with a brief postpartum psychiatric admission (≤ 72h) (2007-2012)(N = 631) were studied using latent class analysis. We identified distinct subtypes of women and compared women within each subtype on post-discharge mental health indicators: physician visits, emergency department (ED) visits and readmissions...
September 11, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28927566/low-rates-of-adverse-events-following-ambulatory-outpatient-total-hip-arthroplasty-at-a-free-standing-surgery-center
#14
Patrick C Toy, Matthew N Fournier, Thomas W Throckmorton, William M Mihalko
BACKGROUND: We proposed to determine the complication and hospital admission rates for patients with total hip arthroplasty (THA) done by a single surgeon in a stand-alone ambulatory surgical center with same-day discharge. Given the recent emphasis on bundled payments for a 90-day episode of care, this same time frame after surgery was chosen to determine patient outcomes. METHODS: The records of patients with THAs done through a direct anterior approach by a single surgeon at 2 separate ambulatory surgery centers were reviewed...
August 26, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28927349/hospital-readmissions-after-elective-lower-extremity-vascular-procedures
#15
Todd R Vogel, Jamie B Smith, Robin L Kruse
Background This study evaluated risk factors associated with 30-day readmission after open and endovascular lower extremity revascularization. Methods Patients admitted with peripheral artery disease and lower extremity procedures were selected from national electronic medical record data, Cerner Health Facts® (2008-2014). Thirty-day readmission was determined. Logistic regression models identified characteristics independently associated with readmission. Results There were 2781 open and 2611 endovascular procedures...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28927185/the-contribution-of-the-composite-of-clinical-process-indicators-as-a-measure-of-hospital-performance-in-the-management-of-acute-coronary-syndromes-insights-from-the-concordance-registry
#16
Bernadette Aliprandi-Costa, James Sockler, Leonard Kritharides, Lucy Morgan, Lan-Chi Snell, Janice Gullick, David Brieger, Isuru Ranasinghe
Aims: Acute coronary syndrome (ACS) is a costly condition for health service provision yet variation in the delivery of care between hospitals persists. A composite measure of adherence with evidence-based clinical-process indicators (CPIs) could better inform hospital performance reporting and clinical outcomes in the management of ACS. Methods: Data on 7444 ACS patients from 39 Australian hospitals were used to derive a hospital-specific composite quality score by calculating mean adherence to 14 evidence-based CPIs...
January 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28926384/effect-of-surgeon-and-hospital-volume-on-morbidity-and-mortality-after-hip-fracture
#17
Kanu Okike, Priscilla H Chan, Elizabeth W Paxton
BACKGROUND: Prior studies have examined the relationship between surgeon and hospital volumes and outcome following hip fracture surgical procedures, but the results have been inconclusive. The purpose of this study was to assess the hip fracture volume-outcome relationship by analyzing data from a large, managed care registry. METHODS: The Kaiser Permanente Hip Fracture Registry prospectively records information on surgically treated hip fractures within the managed health-care system...
September 20, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28926087/self-reported-function-more-informative-than-frailty-phenotype-in-predicting-adverse-postoperative-course-in-older-adults
#18
Alok Kapoor, Theofilos Matheos, Matthias Walz, Christine McDonough, Abiramy Maheswaran, Evan Ruppell, Deeqo Mohamud, Nicholas Shaffer, Yanhua Zhou, Shubjeet Kaur, Stephen Heard, Sybil Crawford, Howard Cabral, Daniel K White, Heena Santry, Alan Jette, Roger Fielding, Rebecca A Silliman, Jerry Gurwitz
BACKGROUND/OBJECTIVE: Current preoperative assessment tools such as the American College of Surgeons Surgical Risk Calculator (ACS Calculator) are suboptimal for evaluating older adults. The objective was to evaluate and compare the performance of the ACS Calculator for predicting risk of serious postoperative complications with the addition of self-reported physical function versus a frailty score. DESIGN: Prospective cohort. SETTING: Two tertiary care academic medical centers in Massachusetts...
September 19, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28925091/counting-the-cost-of-over-the-counter-codeine-containing-analgesic-misuse-a-retrospective-review-of-hospital-admissions-over-a-5-year-period
#19
Deanna Mill, Jacinta L Johnson, Victoria Cock, Emily Monaghan, Elizabeth D Hotham
INTRODUCTION AND AIMS: Combination analgesics containing codeine (CACC) are currently available over-the-counter (OTC) in many countries following a pharmacist's advice. Published case reports detail life-threatening morbidities associated with OTC-CACC misuse, although the cost of treating such patients has not been quantified. This study aims to: (i) identify and detail patients admitted to an Australian tertiary teaching hospital over a 5 year period with sequelae of OTC-CACC misuse; and (ii) estimate the costs of identified hospital admissions...
September 18, 2017: Drug and Alcohol Review
https://www.readbyqxmd.com/read/28925041/patterns-of-collaboration-among-health-care-and-social-services-providers-in-communities-with-lower-health-care-utilization-and-costs
#20
Amanda L Brewster, Marie A Brault, Annabel X Tan, Leslie A Curry, Elizabeth H Bradley
OBJECTIVE: To understand how health care providers and social services providers coordinate their work in communities that achieve relatively low health care utilization and costs for older adults. STUDY SETTING: Sixteen Hospital Service Areas (HSAs) in the United States. STUDY DESIGN: We conducted a qualitative study of HSAs with performance in the top or bottom quartiles nationally across three key outcomes: ambulatory care sensitive hospitalizations, all-cause risk-standardized readmission rates, and average reimbursements per Medicare beneficiary...
September 19, 2017: Health Services Research
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