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https://www.readbyqxmd.com/read/29764686/comparison-of-transcatheter-versus-surgical-aortic-valve-implantation-in-high-risk-patients-a-nationwide-study-in-france
#1
Xavier Armoiry, Jean-François Obadia, Léa Pascal, Stéphanie Polazzi, Antoine Duclos
OBJECTIVE: To compare the clinical outcomes and direct costs at 5 years between transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) using real-world evidence. METHODS: We performed a nationwide longitudinal study using data from the French Hospital Information System from 2009 to 2015. We matched, inside hospitals, 2 cohorts of adults who underwent TAVI or SAVR during 2010 on propensity score based on patient characteristics...
April 7, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29761372/outcomes-of-takotsubo-cardiomyopathy-in-hospitalized-cancer-patients
#2
Parijat Saurav Joy, Achuta Kumar Guddati, Iuliana Shapira
BACKGROUND: Chemotherapy-induced cardiomyopathy is a critical complication of treatment for cancer. The emotional stress of a cancer diagnosis, ongoing chemotherapy, abnormal cancer-related wasting syndrome may contribute to cardiac morbidity in these patients. The burden of Takotsubo Cardiomyopathy (TCM) in cancer patients is unknown. The incidence of TCM and related outcomes in cancer patients was investigated in this study. METHODS: The 2007-2013 National Inpatient Sample (NIS) was analyzed for patients with a prior and new diagnosis of TCM with and without malignancy...
May 14, 2018: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/29754969/pathways-to-drg-based-hospital-payment-systems-in-japan-korea-and-thailand
#3
Peter Leslie Annear, Soonman Kwon, Luca Lorenzoni, Stephen Duckett, Dale Huntington, John C Langenbrunner, Yuki Murakami, Changwoo Shon, Ke Xu
Countries in Asia are working towards achieving universal health coverage while ensuring improved quality of care. One element is controlling hospital costs through payment reforms. In this paper we review experiences in using Diagnosis Related Groups (DRG) based hospital payments in three Asian countries and ask if there is an "Asian way to DRGs". We focus first on technical issues and follow with a discussion of implementation challenges and policy questions. We reviewed the literature and worked as an expert team to investigate existing documentation from Japan, Republic of Korea, and Thailand...
May 7, 2018: Health Policy
https://www.readbyqxmd.com/read/29754661/catheter-ablation-versus-antiarrhythmic-drug-therapy-for-atrial-fibrillation-cabana-trial-study-rationale-and-design
#4
Douglas L Packer, Daniel B Mark, Richard A Robb, Kristi H Monahan, Tristram D Bahnson, Kathleen Moretz, Jeanne E Poole, Alice Mascette, Yves Rosenberg, Neal Jeffries, Hussein R Al-Khalidi, Kerry L Lee
The Catheter Ablation Versus Anti-arrhythmic Drug Therapy for Atrial Fibrillation (CABANA,NCT00911508)(1) trial is testing the hypothesis that the treatment strategy of percutaneous left atrial catheter ablation for the purpose of eliminating atrial fibrillation (AF) is superior to current state-of-the-art pharmacologic therapy. This international 140-center clinical trial was designed to randomize 2200 patients to a strategy of catheter ablation versus state-of-the-art rate or rhythm control drug therapy. Inclusion criteria include: 1) age> 65, or ≤65 with≥ 1 risk factor for stroke, 2) documented AF warranting treatment, and 3) eligibility for both catheter ablation and≥ 2 anti-arrhythmic or≥ 2 rate control drugs...
May 2018: American Heart Journal
https://www.readbyqxmd.com/read/29749130/effects-of-coronary-artery-revascularization-with-a-polymer-free-biolimus-a9-coated-biofreedom-stent-versus-bypass-surgery-before-noncardiac-surgery
#5
Kyu Kim, Choongki Kim, Byeong Keuk Kim, Ji Yong Jang, Ae Young Her, Seunghwan Kim, Sung Jin Hong, Chul Min Ahn, Jung Sun Kim, Young Guk Ko, Donghoon Choi, Myeong Ki Hong, Yangsoo Jang
PURPOSE: The present study aimed to evaluate the efficacy and safety of polymer-free drug-coated BioFreedom stent implantation in comparison to coronary artery bypass graft (CABG) before major noncardiac surgery. MATERIALS AND METHODS: In a multicenter registry, 55 patients required revascularization before major noncardiac surgery that should not be delayed >6 months. Of them, 27 underwent BioFreedom stent implantation and 28 underwent CABG. Primary outcomes included rate of noncardiac surgery, time from revascularization to noncardiac surgery, and occurrence of composite outcomes (all-cause death, myocardial infarction, stent thrombosis, stroke, repeat revascularization, or major bleeding)...
June 2018: Yonsei Medical Journal
https://www.readbyqxmd.com/read/29747650/hospital-financing-of-ischaemic-stroke-determinants-of-funding-and-usefulness-of-drg-subcategories-based-on-severity-of-illness
#6
Sarah Dewilde, Lieven Annemans, Hilde Pincé, Vincent Thijs
BACKGROUND: Several Western and Arab countries, as well as over 30 States in the US are using the "All-Patient Refined Diagnosis-Related Groups" (APR-DRGs) with four severity-of-illness (SOI) subcategories as a model for hospital funding. The aim of this study is to verify whether this is an adequate model for funding stroke hospital admissions, and to explore which risk factors and complications may influence the amount of funding. METHODS: A bottom-up analysis of 2496 ischaemic stroke admissions in Belgium compares detailed in-hospital resource use (including length of stay, imaging, lab tests, visits and drugs) per SOI category and calculates total hospitalisation costs...
May 11, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29724114/does-race-matter-in-universal-healthcare-stroke-cost-and-outcomes-in-us-military-health-care
#7
Matthew D Holtkamp
INTRODUCTION: It is well documented in the US civilian healthcare system that race is correlated with different outcomes for ischemic stroke patients. That healthcare system has wide variations in access to and quality of care. In contrast, the US military healthcare system (MHS) a universal healthcare system where every member has access to the same healthcare benefits. Do racial disparities evident in the civilian healthcare system transfer to the MHS? METHODS: Data was collected from the MHS Military Mart (M2) database from calendar years 2010 through 2015...
May 3, 2018: Ethnicity & Health
https://www.readbyqxmd.com/read/29712518/unruptured-aneurysms-in-the-elderly-perioperative-outcomes-and-cost-analysis-of-endovascular-coiling-and-surgical-clipping
#8
Nicole A Silva, Belinda Shao, Michael J Sylvester, Jean Anderson Eloy, Chirag D Gandhi
OBJECTIVE Observation and neurosurgical intervention for unruptured intracranial aneurysms (UIAs) in the elderly population is rapidly increasing. Cerebral aneurysm coiling (CACo) is favored over cerebral aneurysm clipping (CAC) in elderly patients, yet some elderly individuals still undergo CAC. The cost-effectiveness of treating UIAs requires further exploration. Understanding the effect of intervention on hospital charges and length of stay (LOS) as well as perioperative mortality and complications can further shed light on its economic impact...
May 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29687022/influenza-like-illness-as-a-trigger-for-ischemic-stroke
#9
Amelia K Boehme, Jorge Luna, Erin R Kulick, Hooman Kamel, Mitchell S V Elkind
Objective: We hypothesized that ILI is associated with risk of incident stroke, and that the risk would be highest closest in time to the event. Methods: This case-crossover analysis utilized data obtained from the California State Inpatient Database of the Healthcare Cost and Utilization Project (HCUP). The outcome of interest was ischemic stroke. Exposure was defined as a visit to the emergency department or hospitalization for influenza-like illness (ILI) 365, 180, 90, 30, or 15 days before stroke (risk period) or similar time intervals exactly 1 or 2 years before stroke (control period)...
April 2018: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/29685369/quality-through-coopetition-an-empiric-approach-to-measure-population-outcomes-for-emergency-care-sensitive-conditions
#10
Brendan G Carr, Austin S Kilaru, David N Karp, M Kit Delgado, Douglas J Wiebe
STUDY OBJECTIVE: We develop a novel approach for measuring regional outcomes for emergency care-sensitive conditions. METHODS: We used statewide inpatient hospital discharge data from the Pennsylvania Healthcare Cost Containment Council. This cross-sectional, retrospective, population-based analysis used International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes to identify admissions for emergency care-sensitive conditions (ischemic stroke, ST-segment elevation myocardial infarction, out-of-hospital cardiac arrest, severe sepsis, and trauma)...
April 20, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29666179/increasing-trends-in-hospital-care-burden-of-atrial-fibrillation-in-korea-2006-through-2015
#11
Daehoon Kim, Pil-Sung Yang, Eunsun Jang, Hee Tae Yu, Tae-Hoon Kim, Jae-Sun Uhm, Jong Youn Kim, Hui-Nam Pak, Moon-Hyoung Lee, Boyoung Joung, Gregory Y H Lip
OBJECTIVE: Temporal changes in the healthcare burden of atrial fibrillation (AF) are less well known in rapidly ageing Asian countries. We examined trends in hospitalisations, costs, treatment patterns and outcomes related to AF in Korea. METHODS: Using the National Health Insurance Service (NHIS) database involving the entire adult Korean population (n=41 701 269 in 2015), we analysed a nationwide AF cohort representing 931 138 patients with AF. We studied all hospitalisations due to AF from 2006 to 2015...
April 17, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29664453/cost-burden-of-neuroimaging-during-one-time-admission-for-first-ever-acute-stroke-in-nigeria
#12
Adeleye D Omisore, Morenikeji A Komolafe, Oluwaseun T Esan, Bukunmi M Idowu, Adeniyi S Aderibigbe, Abdul-Majeed K Abidoye, Stephen O Onigbinde
OBJECTIVE: To determine the cost burden of Neuroimaging and its contribution to direct total hospitalization costs (HCs) during one-time admission for first-ever stroke. METHODS: The clinical characteristics, direct itemised costs and total HCs for 170 consecutive patients with first-ever stroke, admitted at our public tertiary health facility over a 15-month period were evaluated. RESULTS: The records of 170 stroke subjects were reviewed...
April 2018: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
https://www.readbyqxmd.com/read/29664359/stroke-care-in-africa-a-systematic-review-of-the-literature
#13
Gerard Urimubenshi, Dominique A Cadilhac, Jeanne N Kagwiza, Olivia Wu, Peter Langhorne
Background Appropriate systems of stroke care are important to manage the increasing death and disability associated with stroke in Africa. Information on existing stroke services in African countries is limited. Aim To describe the status of stroke care in Africa. Summary of review We undertook a systematic search of the published literature to identify recent (1 January 2006-20 June 2017) publications that described stroke care in any African country. Our initial search yielded 838 potential papers, of which 38 publications were eligible representing 14/54 African countries...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29662505/comparison-of-in-hospital-outcomes-between-octogenarians-and-nonagenarians-undergoing-transcatheter-aortic-valve-replacement-a-propensity-matched-analysis
#14
Rajkumar Doshi, Vaibhav Patel, Priyank Shah
Background: Aortic valve stenosis (AS) is very common in the elderly patients above 80 years. Transcatheter aortic valve replacement (TAVR) in such patients is being increasingly performed. This study sought to assess in-hospital outcome differences between octogenarians and nonagenarians and predictors of mortality in nonagenarians undergoing TAVR with severe AS. Method: The study population was derived from the National Inpatient Sample (NIS) for the years 2012-2014 using ICD-9 CM procedure codes 35...
February 2018: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29661135/the-relative-burden-of-community-acquired-pneumonia-hospitalizations-in-older-adults-a-retrospective-observational-study-in-the-united-states
#15
Joshua D Brown, James Harnett, Richard Chambers, Reiko Sato
BACKGROUND: The risk of community-acquired pneumonia (CAP) increases with age and significantly impacts morbidity and mortality in the elderly population. The burden of illness and cost of preventing CAP has not been compared to other serious diseases. METHODS: This retrospective analysis used claims data from 2014 to 2015 and compared hospitalizations for CAP, myocardial infarction (MI), stroke, and osteoporotic fractures (OF) in adults aged ≥65 years enrolled in a Medicare Advantage insurance plan...
April 16, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/29656002/dangers-of-outpatient-nimodipine-use-after-spontaneous-subarachnoid-hemorrhage-in-accordance-with-the-comprehensive-stroke-center-guidelines
#16
Ching-Jen Chen, Cassie Turnage, Jennifer D Sokolowski, Jeyan S Kumar, M Yashar Kalani, Min S Park
Despite the adverse effects and unclear benefit of the complete 21-day course of nimodipine therapy, The Joint Commission mandates adherence to nimodipine treatment for 21 days after hemorrhage or after hospital discharge if discharged within 21 days for Comprehensive Stroke Center (CSC) certification. We hereby present a 67 year-old male patient with Hunt-Hess grade 2 and Fisher grade 3 non-aneurysmal spontaneous subarachnoid hemorrhage who was discharged with oral nimodipine as stipulated by the CSC guidelines, and subsequently developed symptomatic hypotension...
April 11, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29651371/tenecteplase-versus-alteplase-for-the-management-of-acute-ischemic-stroke-in-a-low-income-country-nepal-cost-efficacy-and-safety
#17
REVIEW
Gaurav Nepal, Ghanshyam Kharel, Shaik Tanveer Ahamad, Babin Basnet
Intravenous alteplase is the only approved treatment for acute ischemic stroke. Tenecteplase, a genetically engineered, mutant tissue plasminogen activator, is an alternative thrombolytic agent. The economic feasibility of stroke treatment has been a matter of huge debate and discussion thus far. The use of thrombolytics for the management of ischemic stroke has recently begun in Nepal. In low-income countries like Nepal, where the per capita income falls at just $691.7 and 25.2% of the population are under the poverty line, stroke patients cannot meet treatment expenses...
February 9, 2018: Curēus
https://www.readbyqxmd.com/read/29627171/comparison-of-nicardipine-with-clevidipine-in-the-management-of-hypertension-in-acute-cerebrovascular-diseases
#18
Zachary Rosenfeldt, Katelyn Conklen, Breck Jones, Don Ferrill, Maithili Deshpande, Fazeel M Siddiqui
BACKGROUND AND PURPOSE: In acute stroke, hypertension worsens outcomes. Guidelines do not mention a preferred antihypertensive agent. This present study aimed to compare the efficacy and safety of nicardipine and clevidipine in acute stroke. METHODS: This retrospective review compared nicardipine with clevidipine for hypertension in acute stroke patients from March 17, 2015 to December 23, 2016. Ischemic and hemorrhagic stroke types were evaluated. Patients were excluded if under 18 years, had traumatic brain injury, had intracranial neoplasm, were on dialysis, had both study drugs during the stroke admission, or the study drug was infused for less than 1 hour...
April 4, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29626176/preventive-antibiotics-in-stroke-study-pass-a-cost-effectiveness-study
#19
Willeke F Westendorp, Elles Zock, Jan-Dirk Vermeij, Henk Kerkhoff, Paul J Nederkoorn, Marcel G W Dijkgraaf, Diederik van de Beek
OBJECTIVE: To evaluate the cost-effectiveness of preventive ceftriaxone vs standard stroke unit care without preventive antimicrobial therapy in acute stroke patients. METHODS: In this multicenter, randomized, open-label trial with masked endpoint assessment, 2,550 patients with acute stroke were included between 2010 and 2014. Economic evaluation was performed from a societal perspective with a time horizon of 3 months. Volumes and costs of direct, indirect, medical, and nonmedical care were assessed...
April 6, 2018: Neurology
https://www.readbyqxmd.com/read/29622287/financial-implications-and-impact-of-pre-existing-atrial-fibrillation-on-in-hospital-outcomes-in-patients-who-underwent-transcatheter-aortic-valve-implantation-from-the-national-inpatient-database
#20
Hossam Abubakar, Ahmed S Yassin, Emmanuel Akintoye, Khalid Bakhit, Mohit Pahuja, Mohamed Shokr, Randy Lieberman, Luis Afonso
The objective of this study was to evaluate the financial implications and the impact of pre-existing atrial fibrillation (AF) on in-hospital outcomes in patients who underwent transcatheter aortic valve implantation (TAVI) using the Nationwide Inpatient Sample (NIS) database. We identified patients who underwent TAVI from 2011 to 2014. The primary end point was the effect of pre-existing AF on in-hospital mortality. Secondary end points included periprocedural cardiac complications, stroke, and hemorrhage requiring transfusion...
March 14, 2018: American Journal of Cardiology
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