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https://www.readbyqxmd.com/read/28634502/impact-of-neurological-follow-up-on-early-hospital-readmission-rates-for-acute-ischemic-stroke
#1
Alexander Allen, Todd Barron, Ashley Mo, Richard Tangel, Ruth Linde, Rodney Grim, John Mingle, Ellen Deibert
INTRODUCTION: Despite advances in stroke care, readmission rates for patients with ischemic stroke remain high. Although factors such as age, diabetes, and continuous use of antiplatelet agents have been found to predict readmission rates, the impact of after-hospital care has not been examined. METHODS: The present study reviewed the charts of 416 patients with acute ischemic stroke and recorded stroke-related comorbidities, neurology follow-up within 21 days, readmission at 0 to 30 days, readmission at 31 to 90 days, and any reasons for readmission...
July 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28633147/tranexamic-acid-safely-reduced-blood-loss-in-hemi-and-total-hip-arthroplasty-for-acute-femoral-neck-fracture-a-randomized-clinical-trial
#2
Chad D Watts, Matthew T Houdek, S Andrew Sems, William W Cross, Mark W Pagnano
OBJECTIVES: We aimed to determine whether (1) tranexamic acid (TXA) reduces the incidence of transfusion (2) TXA reduces the calculated blood loss, and (3) there are any observable differences in 30- and 90-day complications with TXA administration during arthroplasty for femoral neck fracture (FNF). DESIGN: Prospective, double-blinded, randomized controlled trial. SETTING: Level 1 Academic Trauma Center. PATIENTS/PARTICIPANTS: One hundred thirty-eight patients who presented with a low-energy, isolated, FNF (AO 31B) treated with either hemi- or total hip arthroplasty within 72 hours of injury were randomized to either the TXA group (69 patients) or placebo group (69 patients)...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28629607/post-operative-management-of-perforated-appendicitis-can-clinical-pathways-improve-outcomes
#3
Robert R Gerard, Barrett A Kielhorn, Laurence E McCahill, Brent Petersen, Andrew J Mullard
BACKGROUND: We sought to decrease organ space infection (OSI) following appendectomy for perforated acute appendicitis (PAA) by minimizing variation in clinical management. OBJECTIVE: A postoperative treatment pathway was developed and four recommendations were implemented: 1) clear documentation of post-operative diagnosis, 2) patients with unknown perforation status to be treated as perforated pending definitive diagnosis, 3) antibiotic therapy to be continued post operatively for 4-7 days after SIRS resolution, and 4) judicious use of abdominal computed tomography (CT) scanning prior to post-operative day 5...
June 10, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28629433/smoking-and-timing-of-cessation-on-postoperative-pulmonary-complications-after-curative-intent-lung-cancer-surgery
#4
Sebastian T Lugg, Theofano Tikka, Paula J Agostini, Amy Kerr, Kerry Adams, Maninder S Kalkat, Richard S Steyn, Pala B Rajesh, Ehab Bishay, David R Thickett, Babu Naidu
BACKGROUND: Smoking is a risk factor for postoperative pulmonary complications (PPC) following non-small cell lung cancer (NSCLC) surgery. The optimal timing for preoperative smoking cessation has not been identified. Our study aimed to observe the impact of preoperative smoking cessation on PPC incidence and other postoperative outcomes including long-term survival. METHODS: A prospective study included consecutive patients following resection for NSCLC in a regional thoracic centre over a 4-year period (2010-2014)...
June 19, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28629340/hospital-readmission-within-10%C3%A2-years-post-stroke-frequency-type-and-timing
#5
Gitta Rohweder, Øyvind Salvesen, Hanne Ellekjær, Bent Indredavik
BACKGROUND: The aim of this study was to examine the hospital readmissions in a 10 year follow-up of a stroke cohort previously studied for acute and subacute complications and to focus on their frequency, their causes and their timing. METHODS: The hospital records of 243 patients, 50% of a cohort of 489 patients acutely and consecutively admitted to our stroke unit in 2002/3, were subjected to review 10 years after the incidental stroke and all acute admissions were examined...
June 19, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28627404/pattern-and-outcome-of-heart-failure-related-hospitalization-over-5-years-in-a-remote-australian-population-a-retrospective-administrative-data-cohort-of-617-indigenous-and-non-indigenous-cases
#6
Camilla Tuttle, Matthew Reeves, Ta-Chi Zhong Hu, Ashley K Keates, Stephen Brady, Graeme Maguire, Simon Stewart
AIMS: To understand the pattern and outcomes for heart failure (HF) related hospitalization among Indigenous and non-Indigenous patients living in Central Australia. METHODS AND RESULTS: A retrospective analysis of administrative data for patients presenting with a primary or secondary diagnosis of HF to Central Australia's Alice Springs Hospital during 2008 to 2012 was performed. The population rate of admission and subsequent outcomes (including case-fatality and readmission) during the 5-year study period were examined...
June 13, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28626991/discharge-against-medical-advice-of-elderly-inpatients-in-the-united-states
#7
Carlijn Lelieveld, Rosanne Leipzig, Licia K Gaber-Baylis, Madhu Mazumdar, Stavros G Memtsoudis, Nicole Zubizarreta, Jashvant Poeran
Discharge against medical advice (DAMA) is associated with greater risk of hospital readmission and higher morbidity, mortality, and costs, but with a rapidly increasing elderly inpatient population, there is a lack of national data on DAMA in this subgroup. The National Inpatient Sample (2003-2013 for trends, 2013 for multivariable analysis, n = 29,290,852) was used to describe trends in DAMA in elderly inpatients, to study diagnosis codes associated with admission, and to assess factors associated with DAMA using multivariable logistic regression...
June 19, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28625669/role-of-language-discordance-in-complication-and-readmission-rate-after-infrainguinal-bypass
#8
Elica Inagaki, Alik Farber, Jeffrey Kalish, Jeffrey J Siracuse, Clara Zhu, Denis V Rybin, Gheorghe Doros, Mohammad H Eslami
OBJECTIVE: Studies have shown that language discordance between treatment teams and patients leads to worse patient outcomes, including longer hospital stays, higher rates of readmission, impaired comprehension of discharge instructions, and lower treatment adherence. Yet, there is a paucity of data evaluating the effects of language discordance on postoperative outcomes among vascular surgery patients. This study compared 30-day postoperative complications and readmissions after nonemergent infrainguinal bypass between non-English-speaking (NES) and English-speaking (ES) patients...
June 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28625377/one-year-mortality-outcomes-and-hospital-readmissions-of-patients-admitted-with-acute-heart-failure-data-from-the-trivandrum-heart-failure-registry-in-kerala-india
#9
Sivadasanpillai Harikrishnan, Ganapathi Sanjay, Anubha Agarwal, N Pratap Kumar, K Krishna Kumar, Charantharayil Gopalan Bahuleyan, Govindan Vijayaraghavan, Sunitha Viswanathan, Madhu Sreedharan, R Biju, N Rajalekshmi, Tiny Nair, Krishnan Suresh, Panniyammakal Jeemon
BACKGROUND: There are sparse data on outcomes of patients with heart failure (HF) from India. The objective was to evaluate hospital readmissions and 1-year mortality outcomes of patients with HF in Kerala, India. METHODS: We followed 1,205 patients enrolled in the Trivandrum Heart Failure Registry for 1 year. A trained research nurse contacted each participant every 3 months using a structured questionnaire which included hospital readmission and mortality information...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28625240/-dynamic-changes-of-complement-level-in-patients-with-acute-coronary-syndrome-and-its-relationships-with-myocardial-injury
#10
Aihong Shao, Xin Qi, Qi Li, Wenjun Jia, Liping Wei, Wenguang Hou, Yanfang Qi, Yue Liu
OBJECTIVE: To study relationships between myocardial injury and the levels of serum complement C3, C4 and C5b-9 in patients with acute coronary syndrome (ACS). METHODS: A retrospectively analysis was conducted. 170 ACS patients [including 110 cases of ST-segment elevation myocardial infarction (STEMI) and 60 cases of non-ST-segment elevation acute coronary syndrome (NSTE-ACS)] with ischemic chest pain or chest discomfort onset within the prior 12 hours admitted to the cardiology department of Tianjin Union Medicine Center from January 2014 to July 2016 were enrolled...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28624716/seizure-related-hospital-admissions-readmissions-and-costs-comparisons-with-asthma-and-diabetes-in-south-australia
#11
Michelle L Bellon, Christopher Barton, Nikki McCaffrey, Denise Parker, Claire Hutchinson
PURPOSE: Seizures are listed as an Ambulatory Care Sensitive Condition (ACSC), where, in some cases, hospitalisation may be avoided with appropriate preventative and early management in primary care. We examined the frequencies, trends and financial costs of first and subsequent seizure-related hospital admissions in the adult and paediatric populations, with comparisons to bronchitis/asthma and diabetes admissions in South Australia between 2012 and 2014. METHODS: De-identified hospital separation data from five major public hospitals in metropolitan South Australia were analysed to determine the number of children and adults admitted for the following Australian Refined Diagnosis Related Groups: seizure related conditions; bronchitis/asthma; and diabetes...
June 10, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28624028/impact-of-long-acting-local-anesthesia-on-clinical-and-financial-outcomes-in-laparoscopic-colorectal-surgery
#12
Deborah S Keller, Rodrigo Pedraza, Reena N Tahilramani, Juan R Flores-Gonzalez, Sergio Ibarra, Eric M Haas
BACKGROUND: Our objective was to assess clinical and financial outcomes with long-acting liposomal bupicavaine (LB) in laparoscopic colorectal surgery. METHODS: Patients that received local infiltration with LB were strictly matched to a control group, and compared for postoperative pain, opioid use, length of stay (LOS), hospital costs, and complication, readmission, and reoperation rates. RESULTS: A total of 70 patients were evaluated in each cohort...
July 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28622740/impact-of-a-pharmacist-managed-heart-failure-postdischarge-bridge-clinic-for-veterans
#13
Genevieve M Hale, Sonia L Hassan, Scott L Hummel, Carrie Lewis, David Ratz, Michael Brenner
BACKGROUND: Hospitals that provide early postdischarge follow-up after heart failure (HF) hospitalization tend to have lower rates of readmission. However, HF postdischarge (bridge) clinics have not been extensively evaluated. OBJECTIVE: To assess the impact of a pharmacist-managed HF bridge clinic in a veteran population. METHODS: HF patients hospitalized from November 2010 to August 2013 were identified. Retrospective chart review was conducted of 122 HF patients seen at bridge clinic compared with 122 randomly selected HF patients not seen at this clinic (usual care)...
July 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28622435/single-port-laparoscopic-ileocaecal-resection-for-crohn-s-disease-a-multicentre-comparison-with-multi-port-laparoscopy
#14
Michele Carvello, E Joline de Groof, Anthony de Buck van Overstraeten, Matteo Sacchi, Albert M Wolthuis, Christianne J Buskens, André D'Hoore, Willem A Bemelman, Antonino Spinelli
BACKGROUND AND AIMS: Single port (SP) ileocecal resection (ICR) is an established technique but there are no large studies comparing SP and multi-port (MP) laparoscopic surgery in Crohn's disease (CD). The aim of this study was to compare postoperative pain scores and analgesia requirements after SP and MP laparoscopic ICR for CD. METHODS: This was a retrospective study of patients undergoing SP or MP ICR for CD in three tertiary referral centres from February 1999-October 2014...
June 16, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28622384/preventability-of-early-vs-late-readmissions-in-an-academic-medical-center
#15
Kelly L Graham, Ogechi Dike, Lauren Doctoroff, Marisa Jupiter, Anita Vanka, Roger B Davis, Edward R Marcantonio
BACKGROUND: It is unclear if the 30-day unplanned hospital readmission rate is a plausible accountability metric. OBJECTIVE: Compare preventability of hospital readmissions, between an early period [0-7 days post-discharge] and a late period [8-30 days post-discharge]. Compare causes of readmission, and frequency of markers of clinical instability 24h prior to discharge between early and late readmissions. DESIGN, SETTING, PATIENTS: 120 patient readmissions in an academic medical center between 1/1/2009-12/31/2010...
2017: PloS One
https://www.readbyqxmd.com/read/28621631/comparative-analysis-of-monotherapy-versus-duotherapy-antiseizure-drug-management-for-postoperative-seizure-control-in-patients-undergoing-an-awake-craniotomy
#16
Chikezie I Eseonu, Francisco Eguia, Oscar Garcia, Peter W Kaplan, Alfredo Quiñones-Hinojosa
OBJECTIVE Postoperative seizures are a common complication in patients undergoing an awake craniotomy, given the cortical manipulation during tumor resection and the electrical cortical stimulation for brain mapping. However, little evidence exists about the efficacy of postoperative seizure prophylaxis. This study aims to determine the most appropriate antiseizure drug (ASD) management regimen following an awake craniotomy. METHODS The authors performed a retrospective analysis of data pertaining to patients who underwent an awake craniotomy for brain tumor from 2007 to 2015 performed by a single surgeon...
June 16, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28620976/oral-nutritional-supplement-use-in-relation-to-length-of-stay-in-heart-failure-patients-at-a-regional-medical-center
#17
Ellen B Babb, James Rohrer
RATIONALE, AIMS, AND OBJECTIVES: Improving the nutritional status of hospitalized patients has been shown to reduce length of stay (LOS), hospital costs, readmission rates, complication rates, and mortality. Provision of nutrient-rich, liquid, oral nutrition supplements (ONS) is one approach to improve nutritional status. Little information is available on ONS use and LOS among heart failure patients. METHODS: This study used a retrospective design to examine whether routine ONS use was associated with hospital LOS among 570 heart failure inpatients (89 ONS = yes; 481 ONS = no) at a regional medical center, adjusting for significant personal, locational, and time variables using multiple logistic regression analysis...
June 16, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28620897/enhanced-recovery-pathway-in-elderly-patients-undergoing-colorectal-surgery-is-there-an-effect-of-increasing-ages-results-from-the-perioperative-italian-society-registry
#18
Marco Braga, Luigi Beretta, Nicolò Pecorelli, Marianna Maspero, Umberto Casiraghi, Felice Borghi, Luca Pellegrino, Stefano Bona, Roberta Monzani, Gianluigi Ferrari, Danilo Radrizzani, Riccardo Iuliani, Carlo Bima, Marco Scatizzi, Giancarlo Missana, Marco Azzola Guicciardi, Andrea Muratore, Michele Crespi, Hedayat Bouzari, Andrea Pisani Ceretti, Ferdinando Ficari
Previous studies reported that enhanced recovery pathway (ERP) is safe in elderly who did not require a specifically tailored protocol. In previous studies, elderly have been considered as a homogeneous cohort and the cut-off value to identify them was different. The aim of the present study is to assess the compliance to ERP and its impact on postoperative outcome in three subgroups of elderly patients with increasing ages. Prospectively collected data entered in an electronic Italian registry specifically designed for ERP were reviewed...
June 15, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28619703/identifying-nonclinical-factors-associated-with-30-day-readmission-in-patients-with-cardiovascular-disease-protocol-for-an-observational-study
#19
Matthew E Dupre, Alicia Nelson, Scott M Lynch, Bradi B Granger, Hanzhang Xu, Janese M Willis, Lesley H Curtis, Eric D Peterson
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of hospitalization in older adults and high readmission rates have attracted considerable attention as actionable targets to promote efficiency in care and to reduce costs. Despite a plethora of research over the past decade, current strategies to predict readmissions have been largely ineffective and efforts to identify novel clinical predictors have been largely unsuccessful. OBJECTIVE: The objective of this study is to examine a wide array of socioeconomic, psychosocial, behavioral, and clinical factors to predict risks of 30-day hospital readmission in cardiovascular patients...
June 15, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28619689/risks-and-benefits-of-opportunistic-salpingectomy-during-vaginal-hysterectomy-a-decision-analysis
#20
Lauren A Cadish, Jonathan P Shepherd, Emma L Barber, Beri Ridgeway
BACKGROUND: Fallopian tubes are commonly removed during laparoscopic and open hysterectomy to prevent ovarian and tubal cancer, but are not routinely removed during vaginal hysterectomy due to perceptions of increased morbidity, difficulty, or inadequate surgical training. OBJECTIVE: We sought to quantify complications and costs associated with a strategy of planned salpingectomy during vaginal hysterectomy. STUDY DESIGN: We created a decision analysis model using TreeAgePro...
June 12, 2017: American Journal of Obstetrics and Gynecology
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