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Surgical readmission

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https://www.readbyqxmd.com/read/28817444/strategies-for-reducing-population-surgical-costs-in-medicare-local-referrals-to-low-cost-hospitals
#1
Hari Nathan, Jyothi R Thumma, Edward C Norton, Justin B Dimick
OBJECTIVE: We sought to assess hospital cost variation for elective inpatient surgical procedures within small geographic areas. SUMMARY BACKGROUND DATA: Previous studies have documented cost variation for inpatient surgical procedures on a national basis, suggesting opportunities for savings. Cost variation within small geographic areas is more relevant to policymakers, providers, and patients, but it has not been studied. METHODS: Using Medicare payment data, we identified elderly patients undergoing 1 of 7 elective inpatient surgical procedures during 2010-2012...
August 16, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28815624/morbidity-and-mortality-in-children-undergoing-bronchoscopy-for-foreign-body-removal
#2
Christopher A Roberts, Michele M Carr
OBJECTIVES/HYPOTHESIS: Analyze morbidity and mortality among children undergoing bronchoscopy for foreign body removal. STUDY DESIGN: Multicenter retrospective review using the American College of Surgeons Pediatric National Surgical Quality Improvement Program from 2014 and 2015. METHODS: Patients were identified using Current Procedural Terminology code 31635. Demographics, time to surgery, operative times, hospitalization time, and complications were collected...
August 17, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28815083/routine-jejunostomy-tube-feeding-following-esophagectomy
#3
Teus J Weijs, Hanneke W J van Eden, Jelle P Ruurda, Misha D P Luyer, Elles Steenhagen, Grard A P Nieuwenhuijzen, Richard van Hillegersberg
BACKGROUND: Malnutrition is an important problem following esophagectomy. A surgically placed jejunostomy secures an enteral feeding route, facilitating discharge with home-tube feeding and long-term nutritional support. However, specific complications occur, and data are lacking that support its use over other enteral feeding routes. Therefore routine jejunostomy tube feeding and discharge with home-tube feeding was evaluated, with emphasis on weight loss, length of stay and re-admissions...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28812150/respiratory-complications-after-colonic-procedures-in-chronic-obstructive-pulmonary-disease-does-laparoscopy-offer-a-benefit
#4
Sarath Sujatha-Bhaskar, Reza Fazl Alizadeh, Colette S Inaba, Christina Y Koh, Mehraneh D Jafari, Steven D Mills, Joseph C Carmichael, Michael J Stamos, Alessio Pigazzi
BACKGROUND: Patients with severe chronic obstructive pulmonary disease (COPD) are at a higher risk for postoperative respiratory complications. Despite the benefits of a minimally invasive approach, laparoscopic pneumoperitoneum can substantially reduce functional residual capacity and raise alveolar dead space, potentially increasing the risk of respiratory failure which may be poorly tolerated by COPD patients. This raises controversy as to whether open techniques should be preferentially employed in this population...
August 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28811986/elderly-age-as-a-risk-factor-for-30-day-postoperative-outcomes-following-elective-anterior-cervical-discectomy-and-fusion
#5
John Di Capua, Sulaiman Somani, Jun S Kim, Kevin Phan, Nathan J Lee, Parth Kothari, Samuel K Cho
STUDY DESIGN: Retrospective analysis of prospectively collected data. OBJECTIVE: Anterior cervical discectomy and fusion (ACDF) is one of the most commonly performed spinal procedures. Considering the high success and low complications rate of ACDF and high prevalence of age-related degeneration of the cervical spine, the rates of ACDF are expected to continually rise. The objective is to identify the association between patient age and 30-day postoperative outcomes following elective ACDF...
August 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28811042/understanding-readmissions-in-children-undergoing-surgery-a-pediatric-nsqip-analysis
#6
Afif N Kulaylat, Dorothy V Rocourt, Anthony Y Tsai, Kathryn L Martin, Brett W Engbrecht, Mary C Santos, Robert E Cilley, Christopher S Hollenbeak, Peter W Dillon
BACKGROUND: Readmission is increasingly being utilized as an important clinical outcome and measure of hospital quality. Our aim was to delineate rates, risk factors, and reasons for unplanned readmission in pediatric surgery. MATERIALS AND METHODS: Retrospective review of pediatric patients (n=130,274) undergoing surgery (2013-2014) at hospitals enrolled in the Pediatric National Surgical Quality Improvement Program (NSQIP-P) was performed. Logistic regression was used to model factors associated with unplanned 30-day readmission...
July 31, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28808930/hospitalization-in-the-year-preceding-major-oncologic-surgery-increases-risk-for-adverse-postoperative-events
#7
Catherine E Sharoky, Karole T Collier, Christopher J Wirtalla, Andrew J Sinnamon, Madalyn G Neuwirth, Lindsay E Kuo, Robert E Roses, Douglas L Fraker, Giorgos C Karakousis, Rachel R Kelz
BACKGROUND: Hospitalization is associated with negative clinical effects that last beyond discharge. This study aimed to determine whether hospitalization in the year before major oncologic surgery is associated with adverse outcomes. METHODS: Patients 18 years of age or older with stomach, pancreas, colon, or rectal cancer who underwent resection in California and New York (2008-2010) were included in the study. Patients with hospitalization in the year prior to oncologic resection (HYPOR) were identified...
August 14, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28808884/outcomes-of-laparoscopic-hiatal-hernia-repair-in-nine-bariatric-patients-with-prior-sleeve-gastrectomy
#8
Francisco Igor B Macedo, Mia Mowzoon, Vijay K Mittal, Mubashir Sabir
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) may exacerbate gastroesophageal reflux disease (GERD) in patients with a hiatal hernia (HH). Surgical repair may be needed, however prior LSG precludes standard HH repair with fundoplication. METHODS: We retrospectively reviewed our experience with bariatric patients with prior LSG undergoing laparoscopic HH repair from August 2010 to July 2016. Patient demographics and outcomes including mortality, length of stay (LOS), readmission rates, reoperation, and complications were described...
August 14, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28807639/a-survey-of-caesarean-section-surgical-site-infections-with-pico%C3%A2-single-use-negative-pressure-wound-therapy-system-in-high-risk-patients-in-england-and-ireland
#9
R J Searle, D Myers
This article reports audit data from the introduction of the PICO™ System for caesarean section patients with high body mass index (BMI) in four hospitals in the UK and Ireland. PICO was used on closed surgical incisions following caesarean section in 399 patients with BMI ≥35kg/m(2). Thirty-six out of 399 patients (9.0%) developed signs of surgical site infection (SSI), a rate lower than a previously reported incidence of 19.3% in a similar population. The readmission incidence was 0.8%. Therefore the use of PICO on closed surgical incisions may be associated with low incidence of SSI and readmission in this high-risk group...
August 11, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28807254/minimally-invasive-gastrectomy-for-gastric-cancer-a-national-perspective-on-oncologic-outcomes-and-overall-survival
#10
Kenneth Leung, Zhifei Sun, Daniel P Nussbaum, Mohamed A Adam, Mathias Worni, Dan G Blazer
BACKGROUND: Minimally invasive (MI) gastrectomy has become increasingly common as a resection technique for gastric cancer; however, data are limited regarding peri-operative morbidity, oncologic outcomes and long-term survival, particularly in the Western patient population. STUDY DESIGN: The 2010-2012 National Cancer Data Base was queried for adult patients who underwent gastrectomy for localized, intestinal-type gastric adenocarcinoma. Patients were classified by surgical approach (MI vs...
September 2017: Surgical Oncology
https://www.readbyqxmd.com/read/28806283/expanding-the-scope-of-quality-measurement-in-surgery-to-include-non-operative-care-results-from-the-acs-nsqip-emergency-general-surgery-pilot
#11
Michael W Wandling, Clifford Y Ko, Paul E Bankey, Chris Cribari, H Gill Cryer, Jose J Diaz, Therese M Duane, S Morad Hameed, Matthew M Hutter, Michael H Metzler, Justin L Regner, Patrick M Reilly, H David Reines, Jason L Sperry, Kristan L Staudenmayer, Garth H Utter, Marie L Crandall, Karl Y Bilimoria, Avery B Nathens
BACKGROUND: Patients managed non-operatively have been excluded from risk-adjusted benchmarking programs, including the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP). Consequently, optimal performance evaluation is not possible for specialties like emergency general surgery (EGS) where non-operative management is common. We developed a multi-institutional EGS clinical data registry within ACS NSQIP that includes patients managed non-operatively to evaluate variability in non-operative care across hospitals and identify gaps in performance assessment that occur when only operative cases are considered...
August 12, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28805599/nationwide-trends-and-in-hospital-complications-of-trachelectomy-for-surgically-resectable-cervical-cancer-in-taiwanese-women-a%C3%A2-population-based-study-1998-2013
#12
Jerry Cheng-Yen Lai, Hung-Hui Chen, Kuei-Hui Chu, Chia-Sui Weng, Yiing-Jenq Chou, Nicole Huang, Yu-Ju Chien, Kung-Liahng Wang
OBJECTIVE: To describe the nationwide trends in the utilization of trachelectomy among Taiwanese women with surgically resectable cervical cancer over the past decade, and to compare associated demographic characteristics, in-hospital complications and related outcomes using a population-based dataset from 1998 to 2013. MATERIALS AND METHODS: We conducted a population-based, cohort study using inpatient admission claims data of Taiwan's National Health Insurance program...
August 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28805345/laparoscopic-sleeve-gastrectomy-improves-renal-transplant-candidacy-and-post-transplant-outcomes-in-morbidly-obese-patients
#13
Y Kim, A D Jung, V K Dhar, J S Tadros, D P Schauer, E P Smith, D J Hanseman, M C Cuffy, R R Alloway, A R Shields, S A Shah, E S Woodle, T S Diwan
Morbid obesity is a barrier to KT due to inferior outcomes, including higher rates of new-onset diabetes after transplantation (NODAT), delayed graft function (DGF), and graft failure. LSG increases transplant eligibility by reducing body mass index (BMI) in KT candidates, but the effect of surgical weight loss on post-transplant outcomes is unknown. Reviewing single-center medical records, we identified all patients who underwent LSG prior to KT from 2011-2016 (n=20). Post-LSG kidney recipients were compared with similar-BMI recipients who did not undergo LSG, using 2:1 direct matching for patient factors...
August 14, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28803638/impact-of-obesity-on-intensive-care-unit-resource-utilization-after-cardiac-operations
#14
Brandon R Rosvall, Keir Forgie, Jeffrey B MacLeod, Alexandra M Yip, Christie Aguiar, Sohrab Lutchmedial, Craig Brown, Rand Forgie, Jean Francois Légaré, Ansar Hassan
BACKGROUND: Much has been published about the effect of obesity on adverse outcomes after cardiac operations, yet little is known regarding the effect of obesity on intensive care unit (ICU) resource utilization. This study examined the effect of obesity on ICU resource utilization after cardiac operations. METHODS: All patients with a body mass index (BMI) of 18.5 kg/m(2) or higher who underwent a cardiac surgical procedure between 2006 and 2013 were stratified into the following weight categories: normal (BMI 18...
July 24, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28803034/variations-in-the-costs-of-radical-cystectomy-for-bladder-cancer-in-the-usa
#15
Jeffrey J Leow, Alexander P Cole, Thomas Seisen, Joaquim Bellmunt, Matthew Mossanen, Mani Menon, Mark A Preston, Toni K Choueiri, Adam S Kibel, Benjamin I Chung, Maxine Sun, Steven L Chang, Quoc-Dien Trinh
BACKGROUND: Radical cystectomy (RC) for muscle-invasive bladder cancer (BCa) has potential for serious complications, prolonged length of stay and readmissions-all of which may increase costs. Although variations in outcomes are well described, less is known about determinants driving variation in costs. OBJECTIVE: To assess surgeon- and hospital-level variations in costs and predictors of high- and low-cost RC. DESIGN, SETTING, AND PARTICIPANTS: Cohort study of 23 173 patients who underwent RC for BCa in 208 hospitals in the USA from 2003 to 2015 in the Premier Healthcare Database...
August 9, 2017: European Urology
https://www.readbyqxmd.com/read/28801219/renal-forniceal-rupture-is-conservative-management-safe
#16
Tara Nikonow Morgan, Jathin Bandari, Mohammed Shahait, Timothy Averch
OBJECTIVE: To outline treatment considerations and outcomes for a cohort of patients with forniceal rupture with the aim of adding to a very limited body of literature regarding clinical practice in this area. METHODS: We retrospectively searched all radiographic records for patients treated at our institution between January 2009 and January 2016 with forniceal rupture. We compiled demographic data, etiology, clinical factors, treatments and outcomes. RESULTS: Of the 103 patients analyzed, the median age at presentation was 64 years (IQR 52-73) and 56 (54%) were female...
August 8, 2017: Urology
https://www.readbyqxmd.com/read/28801217/evaluation-of-unplanned-hospital-readmissions-after-major-urologic-inpatient-surgery-in-the-era-of-accountable-care
#17
Benjamin V Stone, Matthew R Cohn, Nicholas M Donin, Michael Schulster, James S Wysock, Danil V Makarov, Marc A Bjurlin
OBJECTIVE: To provide a multi-institutional analysis of clinical factors predicting unplanned hospital readmission after major inpatient urologic surgery. MATERIALS AND METHODS: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) is a risk-adjusted data collection mechanism for analyzing clinical outcomes data including 30-day perioperative readmissions and complications. We identified 23,108 patients who underwent major inpatient urologic surgery from 2011 to 2012...
August 8, 2017: Urology
https://www.readbyqxmd.com/read/28800859/the-role-of-psychiatric-diagnoses-for-outcome-after-hip-and-knee%C3%A2-arthroplasty
#18
Silas H Gylvin, Christoffer C Jørgensen, Anders F Jensen, Gunnar H Gislason, Henrik Kehlet
BACKGROUND: Surgical patients receiving psychopharmacologic treatment have been associated with adverse outcomes in total hip and knee arthroplasty (THA and TKA). The purpose of this study was to investigate whether a specific high-risk group of patients receiving psychopharmacologic treatment could be identified based upon a nationwide psychiatric diagnosis register. METHODS: From 7 different orthopedic centers, 8288 THA and TKA patients were included from January 2010 to November 2012 of which 943 (11...
July 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28799112/the-dgav-risk-calculator-development-and-validation-of-statistical-models-for-a-web-based-instrument-predicting-complications-of-colorectal-cancer-surgery
#19
Alexander Crispin, Carsten Klinger, Anna Rieger, Brigitte Strahwald, Kai Lehmann, Heinz-Johannes Buhr, Ulrich Mansmann
PURPOSE: The purpose of this study is to provide a web-based calculator predicting complication probabilities of patients undergoing colorectal cancer (CRC) surgery in Germany. METHODS: Analyses were based on records of first-time CRC surgery between 2010 and February 2017, documented in the database of the Study, Documentation, and Quality Center (StuDoQ) of the Deutsche Gesellschaft für Allgemein- und Viszeralchirurgie (DGAV), a registry of CRC surgery in hospitals throughout Germany, covering demography, medical history, tumor features, comorbidity, behavioral risk factors, surgical procedures, and outcomes...
August 10, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28797879/using-a-non-invasive-secure-skin-closure-following-total-knee-arthroplasty-leads-to-fewer-wound-complications-and-no-patient-home-care-visits-compared-to-surgical-staples
#20
Alberto V Carli, Sara Spiro, Brian T Barlow, Steven B Haas
BACKGROUND: Superficial wound complications occur in up to 10% of total knee arthroplasty (TKA) procedures and have been associated with periprosthetic joint infection. The ideal material for TKA closure should offer: 1) fast intraoperative application, 2) minimal wound complications and 3) removable by patients without assistance. We evaluated a novel, non-invasive, removable skin closure system for TKA to determine its effect on wound complications. METHODS: We prospectively evaluated 221 consecutive TKA patients who received skin closure using a non-invasive zipper-like system ('Zip'; Zip 16 Surgical Skin Closure System; Zipline Medical)...
August 7, 2017: Knee
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