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https://www.readbyqxmd.com/read/28228576/ten-year-temporal-trends-in-medical-complications-after-acute-intracerebral-hemorrhage-in-the-united-states
#1
Fadar Oliver Otite, Priyank Khandelwal, Amer M Malik, Seemant Chaturvedi, Ralph L Sacco, Jose G Romano
BACKGROUND AND PURPOSE: Data on medical complications after intracerebral hemorrhage (ICH) are sparse. We assessed trends in the prevalence of urinary tract infection, pneumonia, sepsis, deep venous thrombosis (DVT), pulmonary embolism, acute renal failure (ARF), and acute myocardial infarction after ICH in the United States. METHODS: A total of 575 211 adult ICH cases were identified from the 2004 to 2013 Nationwide Inpatient Sample. Weighted complication risks were computed by sex and mechanical ventilation status...
February 22, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28219665/comparison-of-hospital-outcome-of-transcatheter-versus-surgical-aortic-valve-replacement-in-patients-with-diabetes-mellitus-from-the-nationwide-inpatient-sample
#2
Tomo Ando, Emmanuel Akintoye, Tesfaye Telila, Alexandros Briasoulis, Hisato Takagi, David P Slovut, Theodore Schreiber, Cindy L Grines, Luis Afonso
The comparative outcomes of transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR) in diabetes mellitus (DM) patients are scarce. We aimed to assess and compare the outcomes of TAVR versus SAVR in DM patients using the Nationwide Inpatient Sample database from 2011 to 2013. A complete case analysis was performed for the multivariate analysis and cases with missing data were excluded. The primary end point was in-patient all-cause mortality and secondary outcomes were perioperative complications...
January 25, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28208186/comparison-of-patient-report-and-medical-records-of-comorbidities-results-from-a-population-based-cohort-of-patients-with-prostate-cancer
#3
Fan Ye, Dominic H Moon, William R Carpenter, Bryce B Reeve, Deborah S Usinger, Rebecca L Green, Kiayni Spearman, Nathan C Sheets, Kevin A Pearlstein, Angela R Lucero, Mark R Waddle, Paul A Godley, Ronald C Chen
Importance: The comorbid conditions of patients with cancer affect treatment decisions, which in turn affect survival and health-related quality-of-life outcomes. Comparative effectiveness research studies must account for these conditions via medical record abstraction or patient report. Objective: To examine the agreement between medical records and patient reports in assessing comorbidities. Design, Setting, and Participants: Patient-reported information and medical records were prospectively collected as part of the North Carolina Prostate Cancer Comparative Effectiveness & Survivorship Study, a population-based cohort of 881 patients with newly diagnosed localized prostate cancer enrolled in the North Carolina Central Cancer Registry from January 1, 2011, through June 30, 2013...
February 16, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28208030/intensive-care-unit-admission-and-survival-among-older-patients-with-chronic-obstructive-pulmonary-disease-heart-failure-or-myocardial-infarction
#4
Thomas S Valley, Michael W Sjoding, Andrew M Ryan, Theodore J Iwashyna, Colin R Cooke
RATIONALE: Admission to an intensive care unit (ICU) may be beneficial to pneumonia patients with uncertain ICU needs; however, evidence regarding the association between ICU admission and mortality for other common conditions is largely unknown. OBJECTIVES: To estimate the relationship between ICU admission and outcomes for hospitalized patients with exacerbation of chronic obstructive pulmonary disease (COPD), exacerbation of heart failure (HF), or acute myocardial infarction (AMI)...
February 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28205406/potency-of-human-cardiosphere-derived-cells-from-patients-with-ischemic-heart-disease-is-associated-with-robust-vascular-supportive-ability
#5
Emma Harvey, Huajun Zhang, Pilar Sepúlveda, Sara P Garcia, Dominic Sweeney, Fizzah A Choudry, Delia Castellano, George N Thomas, Hassan Kattach, Romina Petersen, Derek J Blake, David P Taggart, Mattia Frontini, Suzanne M Watt, Enca Martin-Rendon
Cardiosphere-derived cell (CDC) infusion into damaged myocardium has shown some reparative effect; this could be improved by better selection of patients and cell subtype. CDCs isolated from patients with ischemic heart disease are able to support vessel formation in vitro but this ability varies between patients. The primary aim of our study was to investigate whether the vascular supportive function of CDCs impacts on their therapeutic potential, with the goal of improving patient stratification. A subgroup of patients produced CDCs which did not efficiently support vessel formation (poor supporter CDCs), had reduced levels of proliferation and increased senescence, despite them being isolated in the same manner and having a similar immunophenotype to CDCs able to support vessel formation...
February 16, 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28202059/cardiosphere-derived-cells-do-not-improve-cardiac-function-in-rats-with-cardiac-failure
#6
Taís Hanae Kasai-Brunswick, Andréa Rodrigues da Costa, Raiana Andrade Quintanilha Barbosa, Bruna Farjun, Fernanda Cristina Paccola Mesquita, Danúbia Silva Dos Santos, Isalira Peroba Ramos, Grazielle Suhett, Guilherme Visconde Brasil, Sandro Torrentes da Cunha, José Oscar R Brito, Juliana do Amaral Passipieri, Adriana Bastos Carvalho, Antonio Carlos Campos de Carvalho
BACKGROUND: Heart failure represents an important public health issue due to its high costs and growing incidence worldwide. Evidence showing the regenerative potential of postmitotic heart tissue has suggested the existence of endogenous cardiac stem cells in adult hearts. Cardiosphere-derived cells (CDC) constitute a candidate pool of such cardiac stem cells. Previous studies using acute myocardial infarction (MI) models in rodents demonstrated an improvement in cardiac function after cell therapy with CDC...
February 15, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28187777/gmp-conformant-on-site-manufacturing-of-a-cd133-stem-cell-product-for-cardiovascular-regeneration
#7
Anna Skorska, Paula Müller, Ralf Gaebel, Jana Große, Heiko Lemcke, Cornelia A Lux, Manuela Bastian, Frauke Hausburg, Nicole Zarniko, Sandra Bubritzki, Ulrike Ruch, Gudrun Tiedemann, Robert David, Gustav Steinhoff
BACKGROUND: CD133(+) stem cells represent a promising subpopulation for innovative cell-based therapies in cardiovascular regeneration. Several clinical trials have shown remarkable beneficial effects following their intramyocardial transplantation. Yet, the purification of CD133(+) stem cells is typically performed in centralized clean room facilities using semi-automatic manufacturing processes based on magnetic cell sorting (MACS®). However, this requires time-consuming and cost-intensive logistics...
February 10, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28185753/predicting-the-incremental-hospital-cost-of-adverse-events-among-medicare-beneficiaries-in-the-comprehensive-joint-replacement-program-during-fiscal-year-2014
#8
Steven D Culler, David S Jevsevar, Kevin J McGuire, Kevin G Shea, Kenneth M Little, Michael J Schlosser
BACKGROUND: The Medicare program's Comprehensive Care for Joint Replacement (CJR) payment model places hospitals at financial risk for the treatment cost of Medicare beneficiaries (MBs) undergoing lower extremity joint replacement (LEJR). METHODS: This study uses Medicare Provider Analysis and Review File and identified 674,777 MBs with LEJR procedure during fiscal year 2014. Adverse events (death, acute myocardial infarction, pneumonia, sepsis or shock, surgical site bleeding, pulmonary embolism, mechanical complications, and periprosthetic joint infection) were studied...
January 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28185308/medical-cost-savings-in-sakado-city-and-worldwide-achieved-by-preventing-disease-by-folic-acid-fortification
#9
REVIEW
Yasuo Kagawa, Mami Hiraoka, Mitsuyo Kageyama, Yoshiko Kontai, Mayumi Yurimoto, Chiharu Nishijima, Kaori Sakamoto
The introduction of mandatory fortification of grains with folate in 1998 in the United States resulted in 767 fewer spina bifida cases annually and a cost savings of $603 million per year. However, far more significant medical cost savings result from preventing common diseases, including myocardial infarction, stroke, dementia and osteoporosis. A cost-effectiveness analysis showed a gain of 266,649 quality-adjusted life-years and $3.6 billion saved annually, mainly due to the reduction of cardiac infarction...
February 9, 2017: Congenital Anomalies
https://www.readbyqxmd.com/read/28185167/challenges-with-evidence-based-management-of-stable-ischemic-heart-disease
#10
REVIEW
Amit V Patel, Sripal Bangalore
PURPOSE OF REVIEW: Stable ischemic heart disease (SIHD) is a highly prevalent condition associated with increased costs, morbidity, and mortality. Management goals of SIHD can broadly be thought of in terms of improving prognosis and/or improving symptoms. Treatment options include medical therapy as well as revascularization, either with percutaneous coronary intervention or coronary artery bypass grafting. Herein, we will review the current evidence base for treatment of SIHD as well as its challenges and discuss ongoing studies to help address some of these knowledge gaps...
February 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28183505/10-year-clinical-outcome-after-randomization-to-treatment-by-sirolimus-%C3%A2-or-paclitaxel-eluting-coronary%C3%A2-stents
#11
Anders M Galløe, Henning Kelbæk, Leif Thuesen, Henrik S Hansen, Jan Ravkilde, Peter R Hansen, Evald H Christiansen, Ulrik Abildgaard, Ghita Stephansen, Jens F Lassen, Thomas Engstrøm, Jan Skov Jensen, Jørgen L Jeppesen, Niels Bligaard
BACKGROUND: First-generation drug-eluting coronary stents (DES) were introduced in 2003 to 2004, and their use resulted in a considerable reduction in the development of in-stent restenosis at the cost of an increased risk of late stent thromboses. OBJECTIVES: This study followed clinical outcomes of patients included in a large randomized trial for 10 years to enable detection of late changes in annual event rates that could necessitate medical attention. METHODS: A total of 2,098 unselected all-comer patients (50% with acute coronary syndrome) were randomly assigned to have a first-generation DES implanted...
February 14, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28182800/cost-of-acute-kidney-injury-in-hospitalized-patients
#12
Samuel A Silver, Jin Long, Yuanchao Zheng, Glenn M Chertow
BACKGROUND: The economic burden of acute kidney injury (AKI) is not well understood. OBJECTIVE: To estimate the effects of AKI on hospitalization costs and length of stay (LOS). DESIGN: Using data from the 2012 National Inpatient Sample, we compared hospitalization costs and LOS with and without AKI. We used a generalized linear model with a gamma distribution and a log link fitted to AKI to adjust for demographics, hospital differences, and comorbidities...
February 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28179612/ad-hoc-vs-non-ad-hoc-percutaneous-coronary-intervention-strategies-in-patients-with-stable-coronary-artery-disease
#13
Toshiaki Toyota, Takeshi Morimoto, Hiroki Shiomi, Kenji Ando, Koh Ono, Satoshi Shizuta, Takao Kato, Naritatsu Saito, Yutaka Furukawa, Yoshihisa Nakagawa, Minoru Horie, Takeshi Kimura
BACKGROUND: Few studies have evaluated the prevalence and clinical outcomes of ad hoc percutaneous coronary intervention (PCI), performing diagnostic coronary angiography and PCI in the same session, in stable coronary artery disease (CAD) patients.Methods and Results:From the CREDO-Kyoto PCI/CABG registry cohort-2, 6,943 patients were analyzed as having stable CAD and undergoing first PCI. Ad hoc PCI and non-ad hoc PCI were performed in 1,722 (24.8%) and 5,221 (75.1%) patients, respectively...
February 7, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28178979/managed-care-and-inpatient-mortality-in-adults-effect-of-primary-payer
#14
Anika L Hines, Susan O Raetzman, Marguerite L Barrett, Ernest Moy, Roxanne M Andrews
BACKGROUND: Because managed care is increasingly prevalent in health care finance and delivery, it is important to ascertain its effects on health care quality relative to that of fee-for-service plans. Some stakeholders are concerned that basing gatekeeping, provider selection, and utilization management on cost may lower quality of care. To date, research on this topic has been inconclusive, largely because of variation in research methods and covariates. Patient age has been the only consistently evaluated outcome predictor...
February 8, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28166784/randomized-controlled-trial-of-a-coordinated-care-intervention-to-improve-risk-factor-control-after-stroke-or-transient-ischemic-attack-in-the-safety-net-secondary-stroke-prevention-by-uniting-community-and-chronic-care-model-teams-early-to-end-disparities
#15
Amytis Towfighi, Eric M Cheng, Monica Ayala-Rivera, Heather McCreath, Nerses Sanossian, Tara Dutta, Bijal Mehta, Robert Bryg, Neal Rao, Shlee Song, Ali Razmara, Magaly Ramirez, Theresa Sivers-Teixeira, Jamie Tran, Elizabeth Mojarro-Huang, Ana Montoya, Marilyn Corrales, Beatrice Martinez, Phyllis Willis, Mireya Macias, Nancy Ibrahim, Shinyi Wu, Jeremy Wacksman, Hilary Haber, Adam Richards, Frances Barry, Valerie Hill, Brian Mittman, William Cunningham, Honghu Liu, David A Ganz, Diane Factor, Barbara G Vickrey
BACKGROUND: Recurrent strokes are preventable through awareness and control of risk factors such as hypertension, and through lifestyle changes such as healthier diets, greater physical activity, and smoking cessation. However, vascular risk factor control is frequently poor among stroke survivors, particularly among socio-economically disadvantaged blacks, Latinos and other people of color. The Chronic Care Model (CCM) is an effective framework for multi-component interventions aimed at improving care processes and outcomes for individuals with chronic disease...
February 6, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28153648/cost-effectiveness-of-subsidizing-fruit-and-vegetable-purchases-through-the-supplemental-nutrition-assistance-program
#16
Sung Eun Choi, Hilary Seligman, Sanjay Basu
INTRODUCTION: A diet high in fruits and vegetables (FV) is associated with reduced risk of chronic disease. One strategy to incentivize FV consumption among low-income households is to make them more affordable through the Supplemental Nutrition Assistance Program (SNAP). This study aims to identify the cost effectiveness of subsidizing FV purchases among the one in seven Americans who participate in SNAP. METHODS: A cost-effectiveness analysis was conducted from a societal perspective to estimate lifetime costs and health gains associated with subsidizing FV purchases...
January 30, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28150313/improved-outcomes-and-reduced-costs-associated-with-a-health-system-wide-patient-blood-management-program-a-retrospective-observational-study-in-four-major-adult-tertiary-care-hospitals
#17
Michael F Leahy, Axel Hofmann, Simon Towler, Kevin M Trentino, Sally A Burrows, Stuart G Swain, Jeffrey Hamdorf, Trudi Gallagher, Audrey Koay, Gary C Geelhoed, Shannon L Farmer
BACKGROUND: Patient blood management (PBM) programs are associated with improved patient outcomes, reduced transfusions and costs. In 2008, the Western Australia Department of Health initiated a comprehensive health-system-wide PBM program. This study assesses program outcomes. STUDY DESIGN AND METHODS: This was a retrospective study of 605,046 patients admitted to four major adult tertiary-care hospitals between July 2008 and June 2014. Outcome measures were red blood cell (RBC), fresh-frozen plasma (FFP), and platelet units transfused; single-unit RBC transfusions; pretransfusion hemoglobin levels; elective surgery patients anemic at admission; product and activity-based costs of transfusion; in-hospital mortality; length of stay; 28-day all-cause emergency readmissions; and hospital-acquired complications...
February 2, 2017: Transfusion
https://www.readbyqxmd.com/read/28147338/clinical-characteristics-and-improvement-of-the-guideline-based-management-of-acute-myocardial-infarction-in-china-a-national-retrospective-analysis
#18
Lechen Wang, You Zhou, Cheng Qian, Yanggan Wang
OBJECTIVE: This study is to document the clinical characteristics and improvement in management of acute myocardial infarction (AMI) in Chinese population. RESULTS: This study included 64,654 patients (23,805 patients in 2011, 40,849 patients in 2013), of which STEMI and NSTEMI account for 85.09% and 14.91%, respectively. From 2011 to 2013, significant improvement has been achieved in the recanalization rate of PCI (96.01% vs. 98.63%, P < 0.001) and in-hospital deaths (4...
January 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/28139200/-costs-of-healthcare-resource-consumption-after-a-myocardial-infarction-in-france-an-estimate-from-a-medicoadministrative-database-gsb
#19
F Philippe, P Blin, S Bouée, C Laurendeau, E Torreton, J Gourmelin, M Velkovski-Rouyer, L Levy-Bachelot, G Steg
OBJECTIVE: To estimate the costs of healthcare resource consumption in the year preceding and the year following a myocardial infarction (MI). PATIENTS AND METHODS: A historical cohort of patients experiencing an MI in France between 2007 and 2011 was extracted from the échantillon généraliste de bénéficiaires, a 1/97th sample of all beneficiaries of public health insurance in France. RESULTS: A total of 1920 patients experiencing an MI were identified...
January 27, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28134125/hierarchical-testing-of-composite-endpoints-applying-the-win-ratio-to-percutaneous-coronary-intervention-versus-coronary-artery-bypass-grafting-in-the-syntax-trial
#20
Milan Milojevic, Stuart J Head, Eleni-Rosalina Andrinopoulou, Patrick W Serruys, Friedrich W Mohr, Jan G Tijssen, A Pieter Kappetein
AIMS: Compare long-term outcomes of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG), accounting for the clinical impact of individual components in the composite endpoints and prioritizing these using the win ratio (Rw). METHODS AND RESULTS: The win ratio was compared with conventional methods of analyses [hazard ratio (HR) and relative risk] in the SYNTAX trial (n=1800). For the composite of death/stroke/myocardial infarction (MI), the win ratio favoured CABG and was 1...
January 31, 2017: EuroIntervention
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