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Surgical readmission

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https://www.readbyqxmd.com/read/28723873/total-disc-arthroplasty-and-anterior-interbody-fusion-in-the-lumbar-spine-have-relatively-few-differences-in-readmission-and-short-term-adverse-events
#1
Blake N Shultz, Alexander T Wilson, Nathaniel T Ondeck, Patawut Bovonratwet, Ryan P McLynn, Jonathan J Cui, Jonathan N Grauer
STUDY DESIGN: Retrospective matched cohort study of prospectively collected data. OBJECTIVE: To compare rates of adverse events and readmission between lumbar total disc arthroplasty (TDA) and anterior lumbar interbody fusion (ALIF) using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. SUMMARY OF BACKGROUND DATA: TDA and ALIF may be considered for similar degenerative indications. However, there have been few large-cohort comparison studies of short-term clinical outcomes for these procedures...
July 18, 2017: Spine
https://www.readbyqxmd.com/read/28719890/effect-of-neoadjuvant-nab-paclitaxel-plus-gemcitabine-therapy-on-overall-survival-in-patients-with-borderline-resectable-pancreatic-cancer-a-prospective-multicenter-phase-ii-trial-nac-ga-trial
#2
Ken-Ichi Okada, Toshio Shimokawa, Seiko Hirono, Manabu Kawai, Masayuki Sho, Sohei Satoi, Ippei Matsumoto, Hidetoshi Eguchi, Yoshiaki Murakami, Suguru Yamada, Mariko Doi, Hiroki Yamaue
We conducted a prospective multicenter phase II trial of patients with borderline resectable pancreatic carcinoma to investigate the efficacy of neoadjuvant nab-paclitaxel plus gemcitabine therapy on overall survival (OS). The clinical trial primarily evaluated OS time from the first day of protocol therapy as a primary endpoint. The secondary endpoints were recurrence-free survival from the first day of protocol therapy, safety of the protocol therapy (adverse effect), morbidity based on the Clavien Dindo classification of more than III, response rate, preoperative/postoperative tumor marker (CA 19-9, CEA), rate of normalization, reduction rate of the maximum standardized uptake value on positron emission tomography-computed tomography (limited to institutions where positron emission tomography-computed tomography was available), chemotherapeutic effect grade based on Evans' classification, resection rate, R0 resection rate, surgical data (operative time, blood loss, transfusion, postoperative hospital day), overall morbidity rates (reoperation, rate of readmission, mortality), patient rate in postoperative adjuvant therapy (entry rate, completion rate), dose intensity, quality of life regarding fatigue and malaise assessed by the questionnaire of FACIT-F (Japanese version), and peripheral sensory neuropathy assessed by the questionnaire of the FACT/GOG-NTX subscale (version 4; Japanese version)...
July 19, 2017: Oncology
https://www.readbyqxmd.com/read/28719134/development-and-implementation-of-a-clinical-pathway-for-cardiac-surgery-in-the-intensive-care-unit-effects-on-protocol-adherence
#3
Marion van der Kolk, Mark van den Boogaard, Corine Ter Brugge-Speelman, Jeroen Hol, Luc Noyez, Kees van Laarhoven, Hans van der Hoeven, Peter Pickkers
RATIONALE, AIMS AND OBJECTIVES: Cardiac surgery (CS) is facilitated by multiple perioperative guidelines and protocols. Use of a clinical pathway (CP) may facilitate the care of these patients. METHODS: This is a pre-post design study in the ICU of a tertiary referral centre. A CP for CS patients in the ICU was developed by ICU-nurses and enabled them to execute proactively predefined actions in accordance with and within the preset boundaries which were part of a variance report...
July 18, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28716300/the-effect-of-training-level-on-complications-after-free-flap-surgery-of-the-head-and-neck
#4
Jacob S Brady, Meghan M Crippen, Andrey Filimonov, Neil V Nadpara, Jean Anderson Eloy, Soly Baredes, Richard Chan Woo Park
OBJECTIVES: Analyze postoperative complications after free flap surgery based on PGY training level. METHODS: Data on free flap surgeries of the head and neck performed from 2005 to 2013 was collected from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. Cases identifying the status of resident participation in the surgery and the PGY level were included. RESULTS: There were 582 cases with primary surgeon data available...
June 2, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28711516/the-influence-of-metabolic-syndrome-in-the-outcomes-of-colorectal-cancer-patients
#5
André Goulart, Ana Varejão, Fernanda Nogueira, Sandra Martins, António Mesquita-Rodrigues, Nuno Sousa, Pedro Leão
AIMS: Determine the influence of metabolic syndrome and its different components in the outcomes of colorectal cancer surgery at 30days. MATERIALS AND METHODS: Prospective study that included all patients submitted to elective colorectal cancer surgery between August 2015 and August 2016 at Hospital de Braga. Clinical and laboratory parameters evaluated pre-operatively were: central obesity, blood pressure, fasting glucose, triglycerides levels and HDL cholesterol levels...
July 8, 2017: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/28711368/the-safety-and-feasibility-of-early-discharge-following-ileostomy-reversal-a-national-surgical-quality-improvement-program-analysis
#6
Arash Azin, Emily Le Souder, David Urbach, Allan Okrainec, Sami A Chadi, Fayez Quereshy, Timothy D Jackson, Ahmad Elnahas
BACKGROUND: This study aimed to compare 30-day clinical outcomes following routine ileostomy reversal between patients that underwent early discharge (<24 h) and standard discharge (postoperative day [POD] 2 or 3). METHODS: A retrospective cohort analysis was conducted between 2005 and 2014 using the American College of Surgeons National Surgical Quality Improvement Program data set. All patients undergoing ileostomy reversal who were discharged on POD 0 or 1 (early discharge group [EDG]) versus POD 2 or 3 (standard discharge group [SDG]) were identified...
July 12, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28709874/analysis-of-hospital-readmissions-after-prosthetic-urologic-surgery-in-the-united-states-nationally-representative-estimates-of-causes-costs-and-predictive-factors
#7
Filippo Pederzoli, Meera R Chappidi, Sarah Collica, Max Kates, Gregory A Joice, Nikolai A Sopko, Francesco Montorsi, Andrea Salonia, Trinity J Bivalacqua
BACKGROUND: The surgical treatment of urinary incontinence and erectile dysfunction by prosthetic devices has become part of urologic practice, although sparse data exist at a national level on readmissions and hospital costs. AIM: To assess causes and costs of early (≤30 days) and late (31-90 days) readmissions after implantation of penile prostheses (PPs), artificial urinary sphincters (AUSs), or PP + AUS. METHODS: Using the 2013 and 2014 US Nationwide Readmission Databases, sociodemographic characteristics, hospital costs, and causes of readmission were compared among PP, AUS and AUS + PP surgeries...
July 12, 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/28709646/challenge-of-balancing-duration-of-stay-and-readmissions-in-children-s-operation
#8
Heather L Short, Isaac Parakati, Kurt F Heiss, Mark L Wulkan, John F Sweeney, Mehul V Raval
BACKGROUND: Surgeons balance competing interests of minimizing duration of stay with readmissions. Complications that occur early after discharge often result in readmissions. This study examines the relationship between duration of stay, timing of complications, and readmission risk. METHODS: Cases from the 2012-2014 National Surgical Quality Improvement Project-Pediatric were organized into 30 procedural groups. Procedures where duration of stay approximated the median day of complication were identified...
July 11, 2017: Surgery
https://www.readbyqxmd.com/read/28707992/transitional-care-services-a-quality-and-safety-process-improvement-program-in-neurosurgery
#9
Faith C Robertson, Jessica L Logsdon, Hormuzdiyar H Dasenbrock, Sandra C Yan, Siobhan M Raftery, Timothy R Smith, William B Gormley
OBJECTIVE Readmissions increasingly serve as a metric of hospital performance, inviting quality improvement initiatives in both medicine and surgery. However, few readmission reduction programs have targeted surgical patient populations. The objective of this study was to establish a transitional care program (TCP) with the goal of decreasing length of stay (LOS), improving discharge efficiency, and reducing readmissions of neurosurgical patients by optimizing patient education and postdischarge surveillance...
July 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28700450/comparison-of-thirty-day-complications-between-navigated-and-conventional-single-level-instrumented-posterior-lumbar-fusion-a-propensity-score-matched-analysis
#10
Patawut Bovonratwet, Stephen J Nelson, Nathaniel T Ondeck, Benjamin J Geddes, Jonathan N Grauer
STUDY DESIGN: cohort comparison study. OBJECTIVE: To compare perioperative outcomes between navigated and conventional single-level instrumented posterior lumbar fusions in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. SUMMARY OF BACKGROUND DATA: Although multiple studies have investigated the accuracy of pedicle screw placement and radiation exposure with navigation, no study has compared perioperative complications between navigated and conventional posterior lumbar fusion...
July 11, 2017: Spine
https://www.readbyqxmd.com/read/28697116/risk-factors-for-emergency-department-visits-after-hysterectomy-for-benign-disease
#11
Nichole Mahnert, Neil Kamdar, Courtney S Lim, Bethany Skinner, Afton Hassett, Keith E Kocher, Daniel M Morgan, Sawsan As-Sanie
OBJECTIVE: To identify the incidence, indications, and risk factors for emergency department visits that do not result in readmission within 30 days of hysterectomy for benign disease. METHODS: We conducted a secondary data analysis of hysterectomies for benign disease using the Michigan Surgical Quality Collaborative, a statewide group of hospitals that voluntarily reports perioperative outcomes. Hysterectomies for benign disease were abstracted from January 1, 2013, to July 2, 2014...
July 7, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28697106/readmission-after-gynecologic-surgery-a-comparison-of-procedures-for-benign-and-malignant-indications
#12
Lori Cory, Nawar Latif, Colleen Brensinger, Xiaochen Zhang, Robert L Giuntoli, Robert A Burger, Mark Morgan, Emily Ko
OBJECTIVE: To compare 30-day postsurgical readmission rates and associated risk factors for readmission among women undergoing gynecologic surgery for benign and malignant conditions. METHODS: In a retrospective cohort study, we identified patients after surgery for benign and malignant gynecologic conditions in the National Surgical Quality Improvement Program database between January 1, 2011, and December 31, 2012. Data collected included surgical factors, perioperative characteristics, surgical complications, and 30-day readmissions...
July 7, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28693849/impact-of-outpatient-management-following-appendectomy-for-acute-appendicitis-an-acs-nsqip-p-analysis
#13
Cristen N Litz, Laurie Stone, Roberta Alessi, Nebbie E Walford, Paul D Danielson, Nicole M Chandler
BACKGROUND: In 2012, a same-day discharge protocol following appendectomy for acute appendicitis was initiated. Our objective was to determine the success of the protocol by reviewing the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) outcomes following protocol development. METHODS: The 2015 NSQIP-P Participant Use Data File was queried to identify patients with acute appendicitis who underwent appendectomy. Outcomes were compared to institutional outcomes...
June 30, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28693599/determining-the-impact-of-24-7-phone-support-on-hospital-readmissions-after-aortic-valve-replacement-surgery-the-avrre-study-study-protocol-for-a-randomised-controlled-trial
#14
Irene Lie, Stein Ove Danielsen, Theis Tønnessen, Svein Solheim, Marit Leegaard, Leiv Sandvik, Torbjørn Wisløff, Jonny Vangen, Tor Henning Røsstad, Philip Moons
BACKGROUND: Patients undergoing surgical aortic valve replacement (sAVR) have high rates of 30-day readmissions. They also report a low health-related quality of life (HRQOL) and elevated anxiety and depression. The aim of the AVRre study is to determine the efficacy and cost of a 24/7 phone-support intervention in reducing post-discharge readmissions after sAVR. The nature of the support is to help patients better understand and self-manage non-urgent symptoms at home. METHODS/DESIGN: AVRre is a prospective, randomised controlled study comprising 30 days of continuous phone-support intervention and then intermittent follow-up for the first 12 months...
May 30, 2017: Trials
https://www.readbyqxmd.com/read/28691009/endoscopic-vs-microscopic-resection-of-sellar-lesions-a-matched-analysis-of-clinical-and-socioeconomic-outcomes
#15
Tej D Azad, Yu-Jin Lee, Daniel Vail, Anand Veeravagu, Peter H Hwang, John K Ratliff, Gordon Li
BACKGROUND: Direct comparisons of microscopic and endoscopic resection of sellar lesions are scarce, with conflicting reports of cost and clinical outcome advantages. OBJECTIVE: To determine if the proposed benefits of endoscopic resection are realized on a population level. METHODS: We performed a matched cohort study of 9,670 adult patients in the MarketScan database who underwent either endoscopic or microscopic surgery for sellar lesions...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28689682/vaginal-versus-robotic-hysterectomy-for-commonly-cited-relative-contraindications-to-vaginal-hysterectomy
#16
Jennifer J Schmitt, John A Occhino, Amy L Weaver, Michaela E McGree, John B Gebhart
STUDY OBJECTIVE: To compare outcomes of vaginal hysterectomy (VH) and robotic-assisted hysterectomy (RH) among women with conditions perceived as contraindications to VH (uterine size ≥12 weeks' gestation, no vaginal parity, prior cesarean delivery, and obesity). DESIGN: Retrospective chart review. DESIGN CLASSIFICATION: II-2. SETTING: Tertiary US medical center. PATIENTS: Women with VH or RH...
July 6, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28689230/the-extended-transnasal-transsphenoidal-approach-for-anterior-skull-base-meningioma-considerations-in-patient-selection
#17
Joseph P Castlen, David J Cote, Hasan A Zaidi, Edward R Laws
PURPOSE: In this study, we set out to define our institutional criteria for patient eligibility for transsphenoidal resection of parasellar meningiomas, and to report our experience with extended transnasal approaches for these lesions. We aimed to discuss the important considerations of patient selection and risk stratification to optimize outcomes for patients with these difficult lesions, and also include considerations that should be reviewed during surgical approach selection. METHODS: Medical records from Brigham and Women's Hospital were retrospectively reviewed for all patients who underwent transsphenoidal surgery for pituitary disease with the senior author from April 2008 to March 2017 (938 procedures)...
July 8, 2017: Pituitary
https://www.readbyqxmd.com/read/28688827/arthroscopic-versus-open-rotator-cuff-repair-which-has-a-better-complication-and-30-day-readmission-profile
#18
Dustin K Baker, Jorge L Perez, Shawna L Watson, Gerald McGwin, Eugene W Brabston, Parke W Hudson, Brent A Ponce
PURPOSE: To provide a comparative 30-day postoperative analysis of complications and unplanned readmission rates, using the National Surgical Quality Improvement Program database, after open or arthroscopic rotator cuff repair (RCR). METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was reviewed for postoperative complications after open or arthroscopic RCR over an 8-year period, from 2007 through 2014. Patients were identified by use of Current Procedural Terminology codes...
July 5, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28688676/predictors-of-readmissions-after-head-and-neck-cancer-surgery-a-national-perspective
#19
Michelle M Chen, Ryan K Orosco, Jeremy P Harris, Julie B Porter, Eben L Rosenthal, Wendy Hara, Vasu Divi
OBJECTIVES: Surgical oncology patients have multiple comorbidities and are at high risk of readmission. Prior studies are limited in their ability to capture readmissions outside of the index hospital that performed the surgery. Our goal is to evaluate risk factors for readmission for head and neck cancer patients on a national scale. MATERIAL AND METHODS: A retrospective cohort study of head and neck cancer patients in the Nationwide Readmissions Database (2013)...
August 2017: Oral Oncology
https://www.readbyqxmd.com/read/28688645/financial-benefit-of-a-smoking-cessation-program-prior-to-elective-colorectal-surgery
#20
Cameron E Gaskill, Catherine E Kling, Thomas K Varghese, David L Veenstra, Richard C Thirlby, David R Flum, Rafael Alfonso-Cristancho
BACKGROUND: Cigarette smoking increases the risk of postoperative complications nearly 2-fold. Preoperative smoking cessation programs may reduce complications as well as overall postoperative costs. We aim to create an economic evaluation framework to estimate the potential value of preoperative smoking cessation programs for patients undergoing elective colorectal surgery. METHODS: A decision-analytic model from the payer perspective was developed to integrate the costs and incidence of 90-day postoperative complications and readmissions for a cohort of patients undergoing elective colorectal surgery after a smoking cessation program versus usual care...
July 2017: Journal of Surgical Research
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