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https://www.readbyqxmd.com/read/29346256/causes-preventability-and-cost-of-unplanned-rehospitalizations-within-30-days-of-discharge-following-lung-transplantation
#1
Andrew M Courtwright, Derek Zaleski, Lisa Gardo, Vivek N Ahya, Jason D Christie, Maria Crespo, Denis Hadjiliadis, James Lee, Maria Molina, Namrata Patel, Mary Porteous, Edward E Cantu, Christian Bermudez, Joshua M Diamond
BACKGROUND: Unplanned rehospitalizations (UR) within 30 days of discharge are common following lung transplantation. It is unknown whether UR represent preventable gaps in care or necessary interventions for complex patients. The objective of this study was to assess the incidence, causes, risk factors, and preventability of UR following initial discharge after lung transplantation. METHODS: This was a single-center prospective cohort study. Subjects completed a modified Short Physical Performance Battery (SPPB) to assess frailty at listing and at initial hospital discharge after transplantation and the State-Trait Anxiety Inventory (STAI) at discharge...
January 18, 2018: Transplantation
https://www.readbyqxmd.com/read/29344539/agreement-between-heart-failure-patients-and-their-primary-caregivers-on-symptom-assessment
#2
Hassan Sharifi, Mohammad Ali Rezaei, Nastaran Heydari Khayat, Neda Mohammadinia
Background: To decrease the readmission rate of heart failure (HF) patients, patients and their caregivers (CGs) should participate in symptoms assessment. This study aimed to assess the agreement between HF patients and their CGs on symptoms assessment. Methods: Using a correlational design, 100 HF patients with their CGs (100 dyads) were recruited from Department of Cardiology, Iranshahr, during August-December 2014. Data were collected using modified Heart Failure Symptom Survey (HFSS)...
January 2018: International Journal of Community Based Nursing and Midwifery
https://www.readbyqxmd.com/read/29343987/performance-of-the-lace-index-to-predict-30-day-hospital-readmissions-in-patients-with-chronic-obstructive-pulmonary-disease
#3
Maryam A Hakim, Frances L Garden, Matthew D Jennings, Claudia C Dobler
Background and objective: Patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease (COPD) have a high 30-day hospital readmission rate, which has a large impact on the health care system and patients' quality of life. The use of a prediction model to quantify a patient's risk of readmission may assist in directing interventions to patients who will benefit most. The objective of this study was to calculate the rate of 30-day readmissions and evaluate the accuracy of the LACE index (length of stay, acuity of admission, co-morbidities, and emergency department visits within the last 6 months) for 30-day readmissions in a general hospital population of COPD patients...
2018: Clinical Epidemiology
https://www.readbyqxmd.com/read/29340924/impact-of-preoperative-opioid-use-after-emergency-general-surgery
#4
Young Kim, Alexander R Cortez, Koffi Wima, Vikrom K Dhar, Krishna P Athota, Jason J Schrager, Timothy A Pritts, Michael J Edwards, Shimul A Shah
BACKGROUND: Preoperative exposure to narcotics has recently been associated with poor outcomes after elective major surgery, but little is known as to how preoperative opioid use impacts outcomes after common, emergency general surgical procedures (EGS). METHODS: A high-volume, single-center analysis was performed on patients who underwent EGS from 2012 to 2013. EGS was defined as the seven emergent operations that account for 80% of the national burden. Preoperative opioid use was defined as having an active opioid prescription within 7 days prior to surgery...
January 16, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29340918/validation-of-aast-egs-grade-for-acute-pancreatitis
#5
Moustafa Younis, Matthew Hernandez, Mohamed Ray-Zack, Nadeem N Haddad, Asad Choudhry, Pooja Reddy, Martin D Zielinski
BACKGROUND: The AAST recently developed an emergency general surgery (EGS) disease grading system to measure anatomic severity. We aimed to validate this grading system for acute pancreatitis and compare cross sectional imaging-based AAST EGS grade and compare with several clinical prediction models. We hypothesize that increased AAST EGS grade would be associated with important physiological and clinical outcomes and is comparable to other severity grading methods. METHODS: Single institution retrospective review of adult patients admitted with acute pancreatitis during 10/2014-1/2016 was performed...
January 16, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29339639/mri-guided-interstitial-laser-ablation-for-intracranial-lesions-a-large-single-institution-experience-of-133-cases
#6
Ashwin A Kamath, Daniel D Friedman, Carl D Hacker, Matthew D Smyth, David D Limbrick, Albert H Kim, Ammar H Hawasli, Eric C Leuthardt
BACKGROUND: Managing difficult-to-access lesions or surgically accessible lesions in fragile patients is a central problem in neurosurgery. MRI-guided interstitial laser ablation (ILA) is a minimally invasive option that may provide a safe means of treating these challenging patients. OBJECTIVE: We aim to (1) evaluate safety, efficacy, and preliminary outcomes within a diverse and large series of ILA treatments; and (2) report technical details and operative trends that proved useful over time in the authors' experience and that may be of use to neurosurgeons who perform ILA...
January 17, 2018: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/29339433/five-year-mortality-after-transient-ischemic-attack-focus-on-cardiometabolic-comorbidity-and-hospital-readmission
#7
Mohammed Yousufuddin, Nathan Young, Lawrence Keenan, Tammy Olson, Jessica Shultz, Taylor Doyle, Eimad M Ahmmad, Kogulavadanan Arumaithurai, Paul Takahashi, Mohammad Hassan Murad
BACKGROUND AND PURPOSE: We aimed at providing estimates of mortality associated with cardiometabolic comorbidity and incident readmission from cardiometabolic as compared with noncardiometabolic conditions after a first transient ischemic attack. METHODS: Between 2000 and 2015, patients hospitalized for a first transient ischemic attack were examined for cardiometabolic comorbidities (diabetes mellitus, coronary artery disease, heart failure, and atrial fibrillation), 5-year incident hospitalization, and time to death...
January 16, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29338923/minimally-invasive-hysterectomy-surgery-rates-for-endometrial-cancer-performed-at-national-comprehensive-cancer-network-nccn-centers
#8
Jennifer Bergstrom, Alessia Aloisi, Shannon Armbruster, Ting-Tai Yen, Jvan Casarin, Mario M Leitao, Edward J Tanner, Rayna Matsuno, Karime Kalil Machado, Sean C Dowdy, Pamela T Soliman, Stephanie L Wethington, Rebecca L Stone, Kimberly L Levinson, Amanda N Fader
OBJECTIVES: Minimally invasive surgery (MIS) is a quality measure for endometrial cancer (EC) established by the Society of Gynecologic Oncology and the American College of Surgeons. Our study objective was to assess the proportion of EC cases performed by MIS at National Comprehensive Cancer Network (NCCN) centers and evaluate perioperative outcomes. METHODS: A retrospective cohort study of women who underwent surgical treatment for EC from 2013 to 2014 was conducted at four NCCN centers...
January 12, 2018: Gynecologic Oncology
https://www.readbyqxmd.com/read/29338914/prophylactic-antibiotics-following-radical-cystectomy-reduces-urinary-tract-infections-and-readmission-for-sepsis-from-a-urinary-source
#9
Ryan P Werntz, Ann Martinez-Acevedo, Hamed Amadi, Ryan Kopp, Jeffrey La Rochelle, Theresa Koppie, Christopher Amling, Kamran P Sajadi
INTRODUCTION: Urinary tract infections (UTI) and sepsis contribute significantly to the morbidity associated with cystectomy and urinary diversion in the first 30 days. We hypothesized that continuous antibiotic prophylaxis decreased UTIs in the first 30 days following radical cystectomy. METHODS: Patients with urothelial carcinoma of the bladder who underwent a radical cystectomy with urinary diversion for bladder cancer at Oregon Health and Science University from January 2014 to May 2015 were included in the study...
January 12, 2018: Urologic Oncology
https://www.readbyqxmd.com/read/29338867/validation-of-a-definition-of-excessive-postoperative-bleeding-in-infants-undergoing-cardiac-surgery-with-cardiopulmonary-bypass
#10
Rachel S Bercovitz, Allison C Shewmake, Debra K Newman, Robert A Niebler, John P Scott, Eckehard Stuth, Pippa M Simpson, Ke Yan, Ronald K Woods
OBJECTIVE: To derive and validate an objective definition of postoperative bleeding in neonates and infants undergoing cardiac surgery with cardiopulmonary bypass. METHODS: Using a retrospective cohort of 124 infants and neonates, we included published bleeding definitions and cumulative chest tube output over different postoperative periods (eg, 2, 12, or 24 hours after intensive care unit admission) in a classification and regression tree model to determine chest tube output volumes that were associated with red blood cell transfusions and surgical re-exploration for bleeding in the first 24 hours after intensive care unit admission...
December 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29338277/assessment-of-inpatient-psychiatric-readmission-risk-among-patients-discharged-on-an-antipsychotic-polypharmacy-regimen-a-retrospective-cohort-study
#11
Esad Boskailo, Aldin Malkoc, Dustin B McCurry, Jacob Venter, David Drachman, Gilbert M Ramos
OBJECTIVE: Patients are frequently prescribed multiple antipsychotic medications, leading to higher healthcare costs and increased risk for side effects. The efficacy of multiple versus single antipsychotics to prevent acute relapse, measured by incidence of inpatient readmission, is investigated in Arizona, USA. METHOD: A retrospective chart review compared socio-demographic and clinical data from 1,010 patients discharged on a single and 377 discharged on multiple antipsychotic medications...
November 2017: Acta Medica Academica
https://www.readbyqxmd.com/read/29337337/tidig-infektionskonsult-gav-effekt-vid-staphylococcus-aureus-bakteriemi-konsultationen-minskade-%C3%A3-terinl%C3%A3-ggningsfrekvens-och-mortalitet-visar-retrospektiv-studie
#12
Christoffer Ruus, Susann Skovbjerg, Tim Magnusson, Ulrika Snygg-Martin, Marie Studahl, Lars-Magnus Andersson
Automatic infectious disease consultant alert is associated with decreased mortality and readmission rate in Staphylococcus aureus bacteriemia A management plan was implemented at a 2000 bed teaching hospital where positive blood cultures with growth of Staphylococcus aureus were reported simultaneously to the ordering unit and to the Infectious Disease Consultant. Readmission rate and 30-day mortality were compared one year before and one year after introduction of the management plan. Out of totally 320 respectively 321 patients with SAB 252 and 244 were included in the study...
January 16, 2018: Läkartidningen
https://www.readbyqxmd.com/read/29336798/hospital-readmissions-in-children-with-pulmonary-hypertension-a-multi-institutional-analysis
#13
Jordan D Awerbach, George B Mallory, Shelly Kim, Antonio G Cabrera
OBJECTIVE: To assess the rate of and risk factors for 30-day hospital readmission in children with pulmonary hypertension. STUDY DESIGN: The Pediatric Health Information System database was analyzed for patients ≤18 years old with pulmonary hypertension (International Classification of Diseases, Ninth Revision, diagnosis codes of 416.0, 416.1, 416.8, or 416.9) admitted from 2005 through 2014. A generalized hierarchical regression model was used to determine significant ORs and 95% CIs associated with 30-day readmission...
January 12, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29336226/identifying-metrics-before-and-after-readmission-following-head-and-neck-surgery-and-factors-affecting-readmission-rate
#14
Sidharth V Puram, Neil Bhattacharyya
Objectives Determine nationally representative readmission rates after head and neck cancer (HNCA) surgery and factors associated with readmission. Study Design Cross-sectional analysis of admissions database. Methods The 2013 Nationwide Readmissions Database was analyzed for HNCA surgery admissions and subsequent readmission within 30 days. The readmission rate, length of stay (LOS), disposition, mortality rate, and total charges were determined. Diagnoses and procedures upon readmission were quantified. Factors that were associated with readmission were determined...
January 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29334872/labelling-as-reference-centre-of-grace-groupe-francophone-de-r%C3%A3-habilitation-am%C3%A3-lior%C3%A3-e-apr%C3%A3-s-chirurgie-for-colorectal-surgery-its-impact-on-the-implementation-of-enhanced-recovery-programme-at-the-university-hospital-of-li%C3%A3-ge
#15
Coralie Daenen, Carla Coimbra, Grégory Hans, Jean Joris
BACKGROUND: Enhanced recovery programme (ERP) has been used in our hospital since 2005 for selected colorectal surgeries. Since October 2015, after labelling as GRACE reference centre, we included all patients scheduled for elective colorectal surgery in this programme. We assessed the impact of our labelling on the implementation of ERP. METHODS: Results of our first 100 patients entered in the GRACE database were analyzed: length of stay, complications, readmission, adherence to the protocol...
January 15, 2018: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/29332302/preoperative-cognitive-impairment-as-a-predictor-of-postoperative-outcomes-in-a-collaborative-care-model
#16
Kahli Zietlow, Shelley R McDonald, Richard Sloane, Jeffrey Browndyke, Sandhya Lagoo-Deenadayalan, Mitchell T Heflin
OBJECTIVES: To compare postoperative outcomes of individuals with and without cognitive impairment enrolled in the Perioperative Optimization of Senior Health (POSH) program at Duke University, a comanagement model involving surgery, anesthesia, and geriatrics. DESIGN: Retrospective analysis of individuals enrolled in a quality improvement program. SETTING: Tertiary academic center. PARTICIPANTS: Older adults undergoing surgery and referred to POSH (N = 157)...
January 13, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29331355/contemporary-procedural-complications-hospitalizations-and-emergency-visits-after-catheter-ablation-for-atrial-fibrillation
#17
James V Freeman, Grace H Tabada, Kristi Reynolds, Sue Hee Sung, Taylor I Liu, Nigel Gupta, Alan S Go
Contemporary data on complications and resource utilization after atrial fibrillation (AF) ablation are limited. We evaluated rates and risk factors for procedural complication, rehospitalization, and emergency department visits after AF ablation. We identified all adult patients who underwent isolated AF ablation between 2010 and June 2014 in 2 large integrated health-care delivery systems and evaluated rates of acute inpatient complication, 30-day, and 1-year readmission and emergency evaluation. We used multivariable logistic regression to identify predictors of procedural complications, 30-day readmission, or 30-day emergency department evaluation...
December 14, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29331217/the-cost-of-perioperative-complications-following-pancreaticoduodenectomy-a-systematic-review
#18
REVIEW
Jason Wang, Ronald Ma, Leonid Churilov, Paul Eleftheriou, Mehrdad Nikfarjam, Christopher Christophi, Laurence Weinberg
BACKGROUND/OBJECTIVES: Pancreaticoduodenectomy (PD), also known as a Whipple procedure, is commonly performed for a variety of benign and malignant tumours, including of the pancreatic head and surrounding structures. PD is associated with low mortality but high morbidity and costs. Our objective was to describe the financial burden of complications following pancreaticoduodenectomy. METHODS: We searched for articles using the MEDLINE, EMBASE, Cochrane and EconLit databases from the year 2000...
December 19, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/29330739/patterns-and-outcomes-of-prescribing-venous-thromboembolism-prophylaxis-in-hospitalized-older-adults-a-retrospective-cohort-study
#19
Mark Goldin, Jessica Cohen, Alex Makhnevich, Colm Mulvany, Meredith Akerman, Liron Sinvani
Venous thromboembolism (VTE) is a major cause of morbidity and mortality in the United States. Hospitalized, medically ill older adults have increased risk; despite guidelines, data suggest suboptimal pharmacologic prophylaxis rates. Factors influencing provider prescribing non-compliance are unclear. We aimed to describe VTE prophylaxis practices and identify risk factors for, and outcomes of, prescribing non-compliance. A retrospective study was conducted of hospitalized adults aged ≥ 75 years, admitted to the medicine service of a large academic tertiary center from May 1, 2014 to June 30, 2015...
January 12, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29329893/effect-of-short-and-long-term-diabetes-control-on-in-hospital-and-one-year-mortality-rates-in-hospitalized-patients-with-diabetic-foot
#20
Z Feldbrin, M Shargorodsky, J Wainstein, D Melnikov, G Zandman-Goddard
INTRODUCTION: It remains unclear whether diabetic patients with diabetic foot complications benefit from strict glycemic control during hospitalization The present study investigates the effect of short- and long-term diabetes control on hospital outcomes including: in-hospital and one year mortality rates, length of hospital stay and the rate of repeated admissions. METHODS: Type 2 diabetic patients (n = 341) were hospitalized for diabetic foot complications at Wolfson Medical Center over a 5 year period (2008-2012)...
January 9, 2018: European Journal of Internal Medicine
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