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Surgical readmission

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https://www.readbyqxmd.com/read/28633658/nucleated-red-blood-cells-critical-illness-survivors-and-postdischarge-outcomes-a-cohort-study
#1
Steven W Purtle, Clare M Horkan, Takuhiro Moromizato, Fiona K Gibbons, Kenneth B Christopher
BACKGROUND: Little is known about risk factors associated with out-of-hospital outcomes in survivors of critical illness. We hypothesized that the presence of nucleated red blood cells in patients who survived critical care would be associated with adverse outcomes following hospital discharge. METHODS: We performed a two-center observational cohort study of patients treated in medical and surgical intensive care units in Boston, Massachusetts. All data were obtained from the Research Patient Data Registry at Partners HealthCare...
June 21, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28633408/risk-factors-for-readmission-with-cerebrospinal-fluid-leakage-within-30-d-of-vestibular-schwannoma-surgery
#2
Ali A Alattar, Brian R Hirshman, Brandon A McCutcheon, Clark C Chen, Thomas Alexander, Jeffrey Harris, Bob S Carter
BACKGROUND: Cerebrospinal fluid (CSF) leak is a well-recognized complication after surgical resection of vestibular schwannomas and is associated with a number of secondary complications, including readmission and meningitis. OBJECTIVE: To identify risk factors for and timing of 30-d readmission with CSF leak. METHODS: Patients who had undergone surgical resection of a vestibular schwannoma from 1995 to 2010 were identified in the California Office of Statewide Health Planning and Development database...
June 14, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28632890/minimally-invasive-surgery-and-its-impact-on-30-day-postoperative-complications-unplanned-readmissions-and-mortality
#3
A Sood, C P Meyer, F Abdollah, J D Sammon, M Sun, S R Lipsitz, M Hollis, J S Weissman, M Menon, Q-D Trinh
BACKGROUND: A critical appraisal of the benefits of minimally invasive surgery (MIS) is needed, but is lacking. This study examined the associations between MIS and 30-day postoperative outcomes including complications graded according to the Clavien-Dindo classification, unplanned readmissions, hospital stay and mortality for five common surgical procedures. METHODS: Patients undergoing appendicectomy, colectomy, inguinal hernia repair, hysterectomy and prostatectomy were identified in the American College of Surgeons National Surgical Quality Improvement Program database...
June 20, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28632589/emergency-department-visits-following-elective-total-hip-and-knee-replacement-surgery-identifying-gaps-in-continuity-of-care
#4
Micaela A Finnegan, Robyn Shaffer, Austin Remington, Jereen Kwong, Catherine Curtin, Tina Hernandez-Boussard
BACKGROUND: Major joint replacement surgical procedures are common, elective procedures with a care episode that includes both inpatient readmissions and postoperative emergency department (ED) visits. Inpatient readmissions are well studied; however, to our knowledge, little is known about ED visits following these procedures. We sought to characterize 30-day ED visits following a major joint replacement surgical procedure. METHODS: We used administrative records from California, Florida, and New York, from 2010 through 2012, to identify adults undergoing total knee and hip arthroplasty...
June 21, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28619689/risks-and-benefits-of-opportunistic-salpingectomy-during-vaginal-hysterectomy-a-decision-analysis
#5
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
https://www.readbyqxmd.com/read/28619688/single-port-laparoscopy-in-gynecologic-oncology-seven-years-of-experience-at-a-single-institution
#6
Laura Moulton, Amelia M Jernigan, Caitlin Carr, Lindsey Freeman, Pedro F Escobar, Chad M Michener
BACKGROUND: Single port laparoscopy has gained popularity within minimally invasive gynecologic surgery for its feasibility, cosmetic outcomes and safety. However, within gynecologic oncology, there is limited data regarding short-term adverse outcomes and long term hernia risk in patients undergoing single port laparoscopic surgery. OBJECTIVE: To describe short-term outcomes and hernia rates in patients after single port laparoscopy in a gynecologic oncology practice...
June 12, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28619265/comparison-of-surgical-incision-complete-closure-versus-leaving-skin-open-in-wound-class-iv-in-emergent-colon-surgery
#7
Anand Dayama, Catherine A Fontecha, Shahin Foroutan, Jonathan Lu, Sumit Kumar, Nathaniel M Matolo
INTRODUCTION: Our aim was to compare the effect of techniques of wound closure in the emergent colon surgery with wound class IV. METHODS: Using 2014 the colectomy targeted ACS-NSQIP dataset; we identified patients undergoing emergent colectomy with wound class IV. Comparison of surgical incision complete closure versus leaving the skin open and multivariate logistic regression analyses was performed. RESULTS: Of 1792 patients undergoing emergent colectomy with wound class IV, the complete closure cohort had 1376 patients and the incision skin open cohort had 416 patients...
June 3, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28616866/vocal-palsy-increases-the-risk-of-lower-respiratory-tract-infection-in-low-risk-low-morbidity-patients-undergoing-thyroidectomy-for-benign-disease-a-big-data-analysis
#8
S A R Nouraei, J Allen, H Kaddour, S E Middleton, P Aylin, A Darzi, N S Tolley
OBJECTIVES: Thyroidectomy is the commonest and most rapidly-growing operation which places normally-functioning laryngeal nerves at risk of injury. Laryngeal palsy is a major risk-factor for dysphonia, dysphagia, and less commonly, airway obstruction. We investigated the association between post-thyroidectomy vocal palsy and long-term risks of pneumonia and laryngeal failure. DESIGN: An N=near-all analysis of the English administrative dataset using a previously-validated informatics algorithm to identify young and otherwise low-risk patients undergoing thyroidectomy for benign disease...
June 14, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28615506/modified-protocol-for-enhanced-recovery-after-surgery-is-beneficial-for-chinese-cancer-patients-undergoing-pancreaticoduodenectomy
#9
Xiaxing Deng, Xi Cheng, Zhen Huo, Yuan Shi, Zhijian Jin, Haoran Feng, Yue Wang, Chenlei Wen, Hao Qian, Ren Zhao, Weihua Qiu, Baiyong Shen, Chenghong Peng
Radical surgical resection remains the only effective treatment for advanced pancreatic cancer. Effective protocols for recovery from post-operative complications that result in high rates of morbidity and mortality are therefore essential. The enhanced recovery after surgery (ERAS) protocol is an interdisciplinary multimodal concept based on modern anesthesia and analgesia combined with other fast rehabilitation parameters. It was first applied in the field of elective colorectal surgery, and eventually extended to several surgical diseases...
May 23, 2017: Oncotarget
https://www.readbyqxmd.com/read/28614561/association-of-preoperative-anti-tumor-necrosis-factor-therapy-with-adverse-postoperative-outcomes-in-patients-undergoing-abdominal-surgery-for-ulcerative-colitis
#10
Audrey S Kulaylat, Afif N Kulaylat, Eric W Schaefer, Andrew Tinsley, Emmanuelle Williams, Walter Koltun, Christopher S Hollenbeak, Evangelos Messaris
Importance: Despite the increasing use of anti-tumor necrosis factor (TNF) therapy in ulcerative colitis, its effects on postoperative outcomes remain unclear, with many patients requiring surgical intervention despite optimal medical management. Objective: To assess the association of preoperative use of anti-TNF agents with adverse postoperative outcomes. Design, Setting, and Participants: This analysis used insurance claims data from a large national database to identify patients 18 years or older with ulcerative colitis...
June 14, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28607290/technique-of-totally-robotic-delta-shaped-anastomosis-in-distal-gastrectomy
#11
Hidehiko Kitagami, Keisuke Nonoyama, Akira Yasuda, Yo Kurashima, Kaori Watanabe, Shiro Fujihata, Minoru Yamamoto, Yasunobu Shimizu, Moritsugu Tanaka
BACKGROUND: We aimed to clarify the utility of delta-shaped anastomosis (Delta), an intracorporeal Billroth-I anastomosis-based reconstruction technique used after laparoscopy-assisted distal gastrectomy (LADG), in robot-assisted distal gastrectomy (RADG). METHODS: RADG was performed in patients with clinical Stage I gastric cancer, and reconstruction was performed using Delta. The Delta procedure was the same as that performed after LADG, and the operator practiced the procedure in simulated settings with surgical assistants before the operation...
July 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28605552/impact-of-discharge-disposition-on-30-d-readmissions-following-elective-spine-surgery
#12
Raul A Vasquez, Silky Chotai, Thomas H Freeman, Harrison F Kay, Joseph S Cheng, Matthew J McGirt, Clinton J Devin
BACKGROUND: Readmissions are a significant economic burden on the health care system and increasingly being utilized as a metric of quality. Patients discharged to home vs an inpatient facility have different characteristics, which might influence the readmissions following spine surgery. OBJECTIVE: To determine the effect of discharge disposition on readmission rates and causes of readmission after spine surgery. METHODS: Patients enrolled in a prospective registry and undergoing elective spine surgery were analyzed...
June 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28604484/the-effect-of-postoperative-spinal-infections-on-patient-mortality
#13
David S Casper, Benjamin Zmistowski, Douglas A Hollern, Alan S Hilibrand, Alexander R Vaccaro, Gregory D Schroeder, Christopher K Kepler
STUDY DESIGN: Retrospective, matched cohort study OBJECTIVES.: This study aims to (a) investigate the association between SSI and mortality and (b) ascertain any factors that predict mortality in those diagnosed with SSI. SUMMARY OF BACKGROUND DATA: Despite significant efforts towards mitigation, surgical site infection (SSI), including deep infection remains a common complication following spine surgery, Considerable morbidity may be associated with infection, including hospital readmission, revision surgery, and delayed rehabilitation...
June 9, 2017: Spine
https://www.readbyqxmd.com/read/28602533/outpatient-and-inpatient-unicompartmental-knee-arthroplasty-procedures-have-similar-short-term-complication-profiles
#14
Patawut Bovonratwet, Nathaniel T Ondeck, Vineet Tyagi, Stephen J Nelson, Lee E Rubin, Jonathan N Grauer
BACKGROUND: Advances in surgical techniques and anesthesia have made performing unicompartmental knee arthroplasty (UKA) in the outpatient setting a possibility. The touted benefits of outpatient surgery include higher patient satisfaction and reduced costs. However, detailed information on the perioperative outcomes of outpatient compared with inpatient UKA in a large, national patient population in the United States has never been reported. The present study compares perioperative complications between outpatient and inpatient UKAs in the National Surgical Quality Improvement Program database...
May 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28602223/is-enhanced-recovery-enough-for-reducing-30-d-readmissions-after-surgery
#15
Anne C Fabrizio, Michael C Grant, Zishan Siddiqui, Yewande Alimi, Susan L Gearhart, Christopher Wu, Jonathan E Efron, Elizabeth C Wick
BACKGROUND: Few enhanced recovery pathways (ERPs) include processes related to the hospital to home transfer. Little has been reported regarding readmissions in enhanced recovery programs. This study evaluates readmissions and identifies areas to optimize ERPs to prevent readmissions. METHODS: We conducted an observational, retrospective study at a single tertiary care center. Patients in an ERP for colorectal surgery were compared with a similar cohort who underwent surgery before protocol implementation...
April 22, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28602153/frailty-as-a-predictor-of-mortality-in-the-elderly-emergency-general-surgery-patient
#16
Jens Goeteyn, Louis A Evans, Siem De Cleyn, Sigrid Fauconnier, Caroline Damen, Jonathan Hewitt, Wim Ceelen
BACKGROUND: The number of surgical procedures performed in elderly and frail patients has greatly increased in the last decades. However, there is little research in the elderly emergency general surgery patient. The aim of this study was to assess the prevalence of frailty in the emergency general surgery population in Belgium. Secondly, we examined the length of hospital stay, readmission rate and mortality at 30 and 90 days. METHODS: We conducted a prospective observational study at Ghent University Hospital...
June 10, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28601334/variation-in-readmission-expenditures-after-high-risk-surgery
#17
Bruce L Jacobs, Chang He, Benjamin Y Li, Alex Helfand, Naveen Krishnan, Tudor Borza, Amir A Ghaferi, Brent K Hollenbeck, Jonathan E Helm, Mariel S Lavieri, Ted A Skolarus
BACKGROUND: The Hospital Readmissions Reduction Program reduces payments to hospitals with excess readmissions for three common medical conditions and recently extended its readmission program to surgical patients. We sought to investigate readmission intensity as measured by readmission cost for high-risk surgeries and examine predictors of higher readmission costs. MATERIALS AND METHODS: We used the Healthcare Cost and Utilization Project's State Inpatient Database to perform a retrospective cohort study of patients undergoing major chest (aortic valve replacement, coronary artery bypass grafting, lung resection) and major abdominal (abdominal aortic aneurysm repair [open approach], cystectomy, esophagectomy, pancreatectomy) surgery in 2009 and 2010...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28601329/predictors-of-readmission-in-nonagenarians-analysis-of-the-american-college-of-surgeons-national-surgical-quality-improvement-project-dataset
#18
Zachary Hothem, Dustin Baker, Christina S Jenkins, Jason Douglas, Rose E Callahan, Catherine C Shuell, Graham W Long, Robert J Welsh
BACKGROUND: Increased longevity has led to more nonagenarians undergoing elective surgery. Development of predictive models for hospital readmission may identify patients who benefit from preoperative optimization and postoperative transition of care intervention. Our goal was to identify significant predictors of 30-d readmission in nonagenarians undergoing elective surgery. METHODS: Nonagenarians undergoing elective surgery from January 2011 to December 2012 were identified using the American College of Surgeons National Surgical Quality Improvement Project participant use data files...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28601322/the-center-volume-outcome-effect-in-pancreas-transplantation-a-national-analysis
#19
Young Kim, Vikrom K Dhar, Koffi Wima, Andrew D Jung, Brent T Xia, Richard S Hoehn, Tayyab S Diwan, Shimul A Shah
BACKGROUND: Although increased hospital volume has been correlated with improved outcomes in certain surgical procedures, the effect of center volume on pancreas transplantation (PT) is less understood. Our study aims to establish whether a volume-outcome effect exists for PT. METHODS: Through an established linkage between the University HealthSystem Consortium and the Scientific Registry of Transplant Recipients (SRTR) databases, we performed a retrospective cohort analysis of adult PT recipients between 2009 and 2012...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28600373/evaluation-of-a-physiatrist-directed-prehabilitation-intervention-in-frail-patients-with-colorectal-cancer-a-randomised-pilot-study-protocol
#20
Sherman G Wong, Eugene Maida, David Harvey, Natalie Wagner, Ranil Sonnadara, Nalin Amin
INTRODUCTION: Prehabilitation interventions have shown efficacy in the orthopaedic and cardiothoracic surgical populations, but there has been limited evidence for general surgical patients. We present the protocol for a pilot trial of a novel prehabilitation intervention, consisting of a physiatrist-directed preoperative assessment and treatment programme. METHODS AND ANALYSIS: This is a single-centre pilot randomised controlled trial investigating physiatrist-directed prehabilitation for a 4 to 6-week preoperative period...
June 9, 2017: BMJ Open
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